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Frog lateral hips X-ray positioning

An extra hip view, used when a routine one is not enough. The patient lies on their back, the beam passes front to back (AP), straight on to the receptor, and the centring point is the symphysis.

By the ScanFlo Editorial Team · Updated

In this section · X-ray positioning

X-ray positioning/Hip

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

Patient position

Supine. Supine, knees bent and soles together, thighs abducted equally (often paediatric).

Centring & collimation

Central ray

AP

Centre: the symphysis.

Beam: AP, perpendicular to the receptor.

Collimate: both hips

Distance, receptor & grid

SettingValueNotes
SID100 cm
Receptor35 × 43 cmlandscape
PlacementTable buckyGrid in
AngulationNonePerpendicular to the receptor

Marker & breathing

  • Marker: R marker
  • 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)
XS7012.55
S70208
M702510
L704016

These start from a classic film-screen chart (70 kV, 50 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

  • Both femoral heads in lateral, symmetric.
  • 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
Asymmetric abductionOne knee higherAbduct both thighs equally.

Common questions

Where do you centre for a hips frog lateral X-ray?
The centring point is the symphysis.
What distance and beam angle does a hips frog lateral need?
100 cm from the tube to the receptor. The beam passes front to back (AP), straight on to the receptor.
What size receptor, and do you need a grid?
Use a 35 × 43 cm receptor, landscape, 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 hips frog lateral?
Asymmetric abduction. Usual cause: one knee higher. The fix: abduct both thighs equally.

Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a hips frog 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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