Lateral Proximal Femur

Lower Extremity positioning

Lateral Proximal Femur is a radiography positioning projection of the Lower Extremity. Lateral recumbent on affected side. Hip joint included. The centering point is located midway between hip and knee on the affected femur. hip joint must be included.. The central ray is perpendicular to mid femur, centered to include hip joint and a portion of distal femur.. Image-quality criteria include proximal two-thirds of femur including hip joint visible., femoral neck and greater trochanter superimposed.. Standard exposure ranges from 75 to 85 kVp, 12 to 20 mAs, at an SID of 40 inches (102 cm).

Anatomy demonstrated

  • Femoral head and neck in lateral profile.
  • Greater trochanter superimposed over femoral neck.
  • Lesser trochanter projected posteriorly.
  • Proximal two-thirds of the femoral shaft.
  • Acetabulum and hip joint.

Patient preparation

  • Verify patient identity using two identifiers.
  • Remove radiopaque items from the pelvic and femur region.
  • Position patient in lateral recumbent on the affected side.
  • Flex the affected hip and knee slightly for stability.
  • Roll the unaffected leg forward and out of the field.
  • Confirm pregnancy status when applicable.

Position & centering point

Midway between hip and knee on the affected femur. Hip joint must be included.

Central ray

Perpendicular to mid femur, centered to include hip joint and a portion of distal femur.

Exposure / technique

kVp
75–85
mAs
12–20
SID
40" (102 cm)
Notes
Grid required. 14"x17" lengthwise IR. Trauma patients may need cross-table lateral.

Image-quality criteria

  • Proximal two-thirds of femur including hip joint visible.
  • Femoral neck and greater trochanter superimposed.
  • Lesser trochanter visible in profile posteriorly.
  • Soft tissues and trabecular pattern clearly demonstrated.
  • No superimposition of unaffected leg over the proximal femur.

Common errors / ARRT traps

  1. 1 Unaffected leg superimposed over the proximal femur.
  2. 2 Failure to include the hip joint on the receptor.
  3. 3 Rotation of the femur obscures the femoral neck.
  4. 4 Insufficient grid alignment for thick body parts.

Clinical indications

  • Lateral view to complement AP proximal femur for fracture workup.
  • Evaluation of femoral neck or hip joint pathology.
  • Suspected proximal femoral shaft fracture.
  • Post-surgical follow-up of proximal femur hardware.

Aligned to the 2025 ARRT Content Specifications.

Practice this projection live.

The interactive positioning viewer in the app lets you rotate the patient, see the centering point in 3D, and study the central ray angle. Start free.

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