Lateral toes X-ray positioning
An extra foot view, used when a routine one is not enough. The patient lies on their side, the beam passes from side to side, straight on to the receptor, and the centring point is the proximal interphalangeal joint of the toe.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
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- Foot positioning
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Lateral recumbent. The injured toe isolated with tape, the others pulled away.
Centring & collimation
Central ray
lateralCentre: the proximal interphalangeal joint of the toe.
Beam: lateral, perpendicular to the receptor.
Collimate: the toe
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 100 cm | |
| Receptor | 18 × 24 cm | landscape |
| Placement | Tabletop | No grid |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: R or L marker on the side nearest the detector
- Breathing: No breathing instruction needed.
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 size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 46 | 0.5 | 0.5 |
| S | 46 | 0.5 | 0.5 |
| M | 46 | 0.63 | 0.5 |
| L | 46 | 1 | 0.5 |
These start from a classic film-screen chart (46 kV, 10 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
- The toe is clear of the others.
- 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
| Fault | Cause | Fix |
|---|---|---|
| Toes overlap | Not separated | Tape the others away. |
Common questions
- Where do you centre for a toes lateral X-ray?
- The centring point is the proximal interphalangeal joint of the toe.
- What distance and beam angle does a toes 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 × 24 cm receptor, landscape, on the tabletop. No grid is needed.
- Where does the lead marker go?
- R or L marker on the side nearest the detector.
- What goes wrong most often on a toes lateral?
- Toes overlap. Usual cause: not separated. The fix: tape the others away.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a toes lateral in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.