Hip Axiolateral is a radiography positioning projection of the Pelvis. Supine, affected leg extended, opposite leg raised out of the field. Horizontal cross-table CR. SID 40". The centering point is located at femoral neck, midway between medial and lateral aspects of hip joint.. The central ray is horizontal (cross-table), directed perpendicular to the femoral neck.. Image-quality criteria include femoral head circular, not foreshortened., femoral neck shown with minimal foreshortening.. Standard exposure ranges from 75 to 85 kVp, 15 to 25 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Femoral head seen as full circle in axial view.
- Femoral neck shown with minimal foreshortening.
- Greater trochanter entering view from lateral.
- Acetabulum opened inferiorly in axial plane.
- Proximal femoral shaft.
- Hip joint space.
Patient preparation
- Verify patient identity using two identifiers.
- Remove all radiopaque objects from hip region.
- Place patient supine on table.
- Keep the affected leg extended.
- Flex the unaffected hip and knee and raise the leg vertically out of the field.
Position & centering point
At femoral neck, midway between medial and lateral aspects of hip joint.
Central ray
Horizontal (cross-table), directed perpendicular to the femoral neck.
Exposure / technique
- kVp
- 75–85
- mAs
- 15–25
- SID
- 40" (102 cm)
- Notes
- Grid required. CR angled 45 degrees to femoral long axis.
Image-quality criteria
- Femoral head circular, not foreshortened.
- Femoral neck shown with minimal foreshortening.
- Greater trochanter visible, entering view laterally from hip.
- Acetabulum open without distortion.
- Bone trabeculae sharp, no motion blur.
- Collimation: 2 inches beyond hip joint margins.
Common errors / ARRT traps
- 1 CR not perpendicular to the femoral neck foreshortens the neck.
- 2 Grid cutoff from improper IR or grid alignment to the horizontal beam.
- 3 Pelvic tilt obscures hip anatomy symmetry.
- 4 Off-centered CR clips femoral head or neck.
Clinical indications
- Hip fracture evaluation (femoral neck fracture assessment).
- Femoral neck anatomy study.
- Post-operative hip prosthesis position check.
- Hip impingement evaluation.
Aligned to the 2025 ARRT Content Specifications.