Lateral Patella

Lower Extremity positioning

Lateral Patella is a radiography positioning projection of the Lower Extremity. Supine rotated lateral, knee flexed 5-10 degrees. SID 40". The centering point is located center of patella in lateral position.. The central ray is perpendicular to the patella in true lateral.. Image-quality criteria include patella in true lateral profile, not rotated., patellar outline clear and distinct from femur.. Standard exposure ranges from 60 to 70 kVp, 4 to 7 mAs, at an SID of 40 inches (102 cm).

Anatomy demonstrated

  • Patella in true lateral profile.
  • Femoral condyles superimposed posteriorly.
  • Patellofemoral joint space.
  • Articular facets of patella.
  • Anterior femoral cortex.
  • Tibia anterior ridge.

Patient preparation

  • Verify patient identity using two identifiers.
  • Remove shoes and any radiopaque items from the leg.
  • Position patient supine, rotate toward affected knee side.
  • Flex knee 5 to 10 degrees and place on IR in true lateral.
  • Ensure pelvis and hips are aligned.

Position & centering point

Center of patella in lateral position.

Central ray

Perpendicular to the patella in true lateral.

Exposure / technique

kVp
60–70
mAs
4–7
SID
40" (102 cm)
Notes
Slight knee flexion (5-10 degrees) positions patella in true lateral.

Image-quality criteria

  • Patella in true lateral profile, not rotated.
  • Patellar outline clear and distinct from femur.
  • Femoral condyles superimposed and visible behind patella.
  • Patellofemoral joint space open.
  • No superimposition of tibia over patella.
  • Collimation 1.5 inches anterior and posterior, 1 inch on sides.

Common errors / ARRT traps

  1. 1 Knee flexion beyond 10 degrees draws the patella into the patellofemoral joint.
  2. 2 Insufficient flexion rotates patella into oblique view.
  3. 3 Tibia overlaps patella if knee insufficiently flexed.
  4. 4 Off-centered CR clips patella anteriorly or posteriorly.

Clinical indications

  • Patellar fracture evaluation in lateral plane.
  • Assessment of patellar position and tracking.
  • Patellofemoral arthritis and cartilage loss.
  • Post-operative fixation alignment check.

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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