Cross-table lateral hip X-ray positioning (horizontal beam)
An extra hip view, used when a routine one is not enough. The patient lies on their back, the beam passes from side to side, tilted 30° towards the midline with the tube horizontal, and the centring point is the femoral neck.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Supine. Do not move the injured leg. Raise and support the uninjured leg; the patient holds the detector with a loose grid against the injured hip.
Centring & collimation
Central ray
lateralCentre: the femoral neck.
Beam: lateral, angled 30° medial, horizontal beam.
Collimate: the femoral head, neck and trochanters
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 120 cm | Horizontal beam |
| Receptor | 24 × 30 cm | portrait |
| Placement | Tabletop | Grid in |
| Angulation | 30° | medial |
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 size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 80 | 50 | 20 |
| S | 80 | 80 | 32 |
| M | 80 | 100 | 40 |
| L | 80 | 160 | 63 |
These start from a classic film-screen chart (80 kV, 125 mAs at 140 cm) and are adjusted for a digital detector at 120 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 neck is shown in lateral with the head in the acetabulum.
- 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 |
|---|---|---|
| Soft tissue of the other thigh over the neck | Other leg not raised | Raise the uninjured leg. |
Common questions
- Where do you centre for a hip lateral (horizontal beam) X-ray?
- The centring point is the femoral neck.
- What distance and beam angle does a hip lateral (horizontal beam) need?
- 120 cm from the tube to the receptor. The beam passes from side to side, tilted 30° towards the midline with the tube horizontal.
- What size receptor, and do you need a grid?
- Use a 24 × 30 cm receptor, portrait, on the tabletop. 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 hip lateral (horizontal beam)?
- Soft tissue of the other thigh over the neck. Usual cause: other leg not raised. The fix: raise the uninjured leg.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a hip lateral (horizontal beam) in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.