Lateral Knee

Lower Extremity positioning

Lateral Knee is a radiography positioning projection of the Lower Extremity. Supine rotated lateral, knee flexed 20-30 degrees. SID 40". The centering point is located knee joint, knee flexed 20-30 degrees in true lateral.. The central ray is 5-7 degrees cephalad to the knee joint.. Image-quality criteria include medial and lateral femoral condyles superimposed in true lateral., knee joint space open showing anterior and posterior compartments.. Standard exposure ranges from 60 to 75 kVp, 5 to 10 mAs, at an SID of 40 inches (102 cm).

Anatomy demonstrated

  • Distal femur with condyles superimposed.
  • Tibial plateau in lateral relationship.
  • Patella in lateral profile.
  • Femorotibial joint space in lateral aspect.
  • Anterior and posterior joint recesses.
  • Proximal fibula visible posterior.

Patient preparation

  • Verify patient identity using two identifiers.
  • Remove shoes and any radiopaque items from the leg.
  • Position patient supine, roll toward lateral side of affected knee.
  • Flex knee 20 to 30 degrees and adjust on IR in true lateral.
  • Place support roll under the flexed knee for comfort.

Position & centering point

Knee joint, knee flexed 20-30 degrees in true lateral.

Central ray

5-7 degrees cephalad to the knee joint.

Exposure / technique

kVp
60–75
mAs
5–10
SID
40" (102 cm)
Notes
Knee flexed 20-30 degrees allows visualization of posterior joint.

Image-quality criteria

  • Medial and lateral femoral condyles superimposed in true lateral.
  • Knee joint space open showing anterior and posterior compartments.
  • Patella in true lateral position, not rotated.
  • Fibula visible posteriorly and not superimposed on tibia.
  • Anterior and posterior joint recesses clearly visualized.
  • Collimation 1.5 inches anterior and posterior, 1.5 inches above and below.

Common errors / ARRT traps

  1. 1 Insufficient knee flexion prevents visualization of posterior compartment.
  2. 2 Excessive flexion closes joint space and obscures anatomy.
  3. 3 Medial or lateral rotation distorts condylar superimposition.
  4. 4 Off-centered CR clips patella or posterior condyles.

Clinical indications

  • Knee trauma evaluation, posterior condyle or plateau fracture.
  • Assessment of knee effusion and fat pad sign.
  • Anterior or posterior knee subluxation evaluation.
  • Post-operative follow-up in lateral plane.

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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