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Lateral femur X-ray positioning

One of the routine femur views. The patient lies on their side, the beam passes from side to side, straight on to the receptor, and the centring point is the mid-shaft.

By the ScanFlo Editorial Team · Updated

In this section · X-ray positioning

X-ray positioning/Femur

Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.

Patient position

Lateral recumbent. On the side examined with the leg straight; the other leg bent forward.

Centring & collimation

Central ray

lateral

Centre: the mid-shaft.

Beam: lateral, perpendicular to the receptor.

Collimate: knee and as much shaft as possible

Distance, receptor & grid

SettingValueNotes
SID100 cm
Receptor18 × 43 cmportrait
PlacementTable buckyGrid in
AngulationNonePerpendicular to the receptor

Marker & breathing

  • Marker: R or L marker on the side nearest the detector
  • Breathing: Suspend respiration.

Exposure by patient size

Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.

Patient sizekVmAs (chart)mAs (DR default)
XS706.32.5
S70104
M7012.55
L70208
Child5320.8

These start from a classic film-screen chart (70 kV, 25 mAs at 140 cm) and are adjusted for a digital detector at 100 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.

Image quality checklist

  • Condyles superimposed.
  • The anatomical side marker is visible, correct and clear of the anatomy.
  • Collimation borders are visible on all sides, no wider than the area requested.

Faults & how to fix them

FaultCauseFix
Other leg over the femurNot bent forwardBend the other leg forward.

Common questions

Where do you centre for a femur lateral X-ray?
The centring point is the mid-shaft.
What distance and beam angle does a femur lateral need?
100 cm from the tube to the receptor. The beam passes from side to side, straight on to the receptor.
What size receptor, and do you need a grid?
Use an 18 × 43 cm receptor, portrait, in the table bucky. A grid is needed.
What should the patient do with their breathing?
Ask them to stop breathing for the moment of the exposure.
What goes wrong most often on a femur lateral?
Other leg over the femur. Usual cause: not bent forward. The fix: bend the other leg forward.

Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a femur lateral in a 3D room and score your positioning. See ScanFlo XR →

Written by the ScanFlo team from everyday radiographic practice.

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