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Mnemonics, Simplified Concepts & Thoughts

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Mnemonics, Simplified Concepts & Thoughts

Iliac Cortical Density (ICD)

Epomedicine, Jun 13, 2025Jun 13, 2025

Synonym: Iliac Cortical Line

Iliac cortical densities (ICD) are the overlap of the true pelvis posterior to the acetabulum which is used as a proxy for the slope of the sacral ala.

iliac cortical density
Doi, Toshio & Tono, Osamu & Tarukado, Kiyoshi & Harimaya, Katsumi & Matsumoto, Yoshihiro & Hayashida, Mitsumasa & Okada, Seiji & Iwamoto, Yukihide. (2015). A new sagittal parameter to estimate pelvic tilt using the iliac cortical density line and iliac tilt: A retrospective X-ray measurement study. Journal of orthopaedic surgery and research. 10. 115. 10.1186/s13018-015-0262-0. [CC BY 4.0]

Importance:

The entry point should be anterior in S1 and inferior to the iliac cortical density (ICD), which parallels the sacral alar slope, usually slightly caudal and posterior. The ICD thus marks the anterosuperior boundary of the safe zone for an iliosacral screw which may injure the L5 nerve root if it penetrates this cortex.

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PGMEE, MRCS, USMLE, MBBS, MD/MS Musculoskeletal systemOrthopedics

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Epomedicine. Iliac Cortical Density (ICD) [Internet]. Epomedicine; 2025 Jun 13 [cited 2026 Nov 2]. Available from: https://epomedicine.com/medical-students/iliac-cortical-density-icd/.

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