Oblique lateral hip X-ray positioning (suspected fracture)
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 25° towards the midline, 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 leg. Bring the trolley alongside the bucky with the injured hip nearest it; angle the tube arm 25° so the bottom of the holder touches the trolley.
Centring & collimation
Central ray
lateralCentre: the femoral neck.
Beam: lateral, angled 25° medial.
Collimate: the hip joint and upper femur
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 120 cm | |
| Receptor | 24 × 30 cm | portrait |
| Placement | Erect (wall) bucky | Grid in |
| Angulation | 25° | 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 | 32 | 12.5 |
| S | 80 | 50 | 20 |
| M | 80 | 63 | 25 |
| L | 80 | 100 | 40 |
These start from a classic film-screen chart (80 kV, 80 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 femoral neck is shown in a second plane without moving the leg.
- 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 |
|---|---|---|
| Neck not shown | Holder not touching the trolley | Bring the holder down onto the trolley. |
Common questions
- Where do you centre for a hip oblique lateral (suspected fracture) X-ray?
- The centring point is the femoral neck.
- What distance and beam angle does a hip oblique lateral (suspected fracture) need?
- 120 cm from the tube to the receptor. The beam passes from side to side, tilted 25° towards the midline.
- What size receptor, and do you need a grid?
- Use a 24 × 30 cm receptor, portrait, in the wall 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 hip oblique lateral (suspected fracture)?
- Neck not shown. Usual cause: holder not touching the trolley. The fix: bring the holder down onto the trolley.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a hip oblique lateral (suspected fracture) in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.