Calcaneus Lateral (Mediolateral) is a radiography positioning projection of the Lower Extremity. Patient lateral recumbent on affected side, CR perpendicular to calcaneus. SID 40". The centering point is located calcaneal tuberosity with lateral border of foot on ir.. The central ray is perpendicular to the calcaneus in true lateral projection.. Image-quality criteria include entire calcaneus visible in true lateral without rotation., talocalcaneal articulation clearly demonstrated.. Standard exposure ranges from 60 to 70 kVp, 4 to 8 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Calcaneus in true lateral profile.
- Calcaneal tuberosity in profile.
- Anterior process of the calcaneus.
- Talocalcaneal joint articulation open.
- Talar dome and neck.
- Medial and lateral ankle malleoli.
Patient preparation
- Verify patient identity using two identifiers.
- Remove footwear, socks, and any radiopaque foot jewelry.
- Position the patient lateral recumbent on the affected side.
- Place the affected foot on the IR with the lateral border down.
- Flex the knee slightly for patient comfort and stability.
Position & centering point
Calcaneal tuberosity with lateral border of foot on IR.
Central ray
Perpendicular to the calcaneus in true lateral projection.
Exposure / technique
- kVp
- 60–70
- mAs
- 4–8
- SID
- 40" (102 cm)
- Notes
- Position patient on affected side. Flex knee if needed for comfort.
Image-quality criteria
- Entire calcaneus visible in true lateral without rotation.
- Talocalcaneal articulation clearly demonstrated.
- Calcaneal tuberosity shown in profile.
- Anterior process of calcaneus clearly visible.
- Medial and lateral malleoli at the ankle joint visible.
- Collimation: 1 inch on all sides of calcaneus, include heel and base of 5th metatarsal.
Common errors / ARRT traps
- 1 Medial or lateral rotation distorts the true lateral projection.
- 2 Plantar flexion or dorsiflexion tilts the calcaneus.
- 3 Off-centered CR clips the tuberosity or anterior process.
- 4 Lifting the lateral border off the IR distorts the foot position.
Clinical indications
- Suspected calcaneal fracture or stress fracture.
- Evaluation of calcaneal spur or heel pain.
- Assessment of talocalcaneal articulation.
Aligned to the 2025 ARRT Content Specifications.