Hip Lateral is a radiography positioning projection of the Pelvis. Supine frog-leg, non-trauma only, affected femur abducted 45 degrees with hip and knee flexed. SID 40". The centering point is located at the femoral neck, the same point as the AP hip: about 2.5 inches distal to the midpoint of the ASIS-pubic symphysis line (Bontrager). Merrill's Lauenstein method instead directs the CR through the hip joint, midway between the ASIS and the pubic symphysis. Follow your program's source. The central ray is perpendicular to IR at the level of the femoral neck. Image-quality criteria include femoral neck in profile, superimposed by the greater trochanter, acetabulum open and clearly demonstrated. A sample technique is 85 kVp with DR 9 or CR 18 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Femoral head in profile.
- Femoral neck in profile.
- Acetabulum opened in lateral view.
- Proximal femoral shaft.
- Hip joint space.
Patient preparation
- CONTRAINDICATED in destructive hip disease or potential hip fracture or dislocation (Bontrager), or any suspected fracture or pathologic condition (Merrill's), because it can displace fracture fragments, and after hip replacement: use the Danelius-Miller axiolateral instead.
- Verify patient identity using two identifiers.
- Remove all radiopaque objects from hip region.
- Place patient supine on table.
- Flex the affected hip and knee, then abduct the femur 45 degrees from vertical.
- Place the sole of the affected foot against the medial side of the opposite knee.
- Keep the unaffected leg extended flat on the table.
Position & centering point
At the femoral neck, the same point as the AP hip: about 2.5 inches distal to the midpoint of the ASIS-pubic symphysis line (Bontrager). Merrill's Lauenstein method instead directs the CR through the hip joint, midway between the ASIS and the pubic symphysis. Follow your program's source.
Central ray
Perpendicular to IR at the level of the femoral neck.
Exposure / technique
- kVp
- 85
- mAs
- DR 9 / CR 18
- SID
- 40" (102 cm)
- Notes
- Grid required. 45 degrees of abduction suits the general proximal femur; 20-30 degrees shows the femoral neck without foreshortening. Sample technique: DR 9 / CR 18 mAs at 85 kVp, 40 in SID, for an 18 cm part (Merrill's sample chart). Adjust for your equipment.
kVp and mAs are sample values. Use caution when applying them in your department.
Image-quality criteria
- Femoral neck in profile, superimposed by the greater trochanter.
- Acetabulum open and clearly demonstrated.
- Femoral neck at the center of the collimated field.
- No motion blur; bone trabeculae sharp.
- Collimated on four sides to the area of interest.
Common errors
- 1 Abducting well past 45 degrees foreshortens the neck; 20-30 degrees shows the neck best.
- 2 Femoral neck not at the center of the collimated field shows improper centering.
Clinical indications
- Non-traumatic hip pathology, assessed in the lateral profile.
- Not for destructive hip disease or a hip replacement: use the Danelius-Miller axiolateral.