The lateral femur view for pediatrics is part of a standard series examining the femur in its entirety, including the hip and knee joint.
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Indications
This view demonstrates the femur in an orthogonal position to the AP view. This allows assessment of suspected dislocations, fractures, localizing foreign bodies and osteomyelitis within the long bone. Depending on departments, this view can be crucial for orthopedic surgeons to determine the length of the femur for prosthetic purposes.
Patient position
patient is rolled at least 45° onto the side of interest
the unaffected leg is bent to stabilize the patient's position i.e. foot firm on the bed to ensure stability
to acquire the entire femur in one image, it may be necessary to place the detector in a diagonal position parallel to the femur
Technical factors
anteroposterior projection
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centering point
mid femur region
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collimation
laterally to the skin margins
superior to ASIS
inferior to proximal third of tibia/fibula
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orientation
portrait
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detector size
30 cm x 43 cm
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exposure 1
63-70 kVp
1.6-2.5 mAs
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SID
100 cm
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grid
no
Image technical evaluation
greater and lesser trochanters should be superimposed by the femoral neck
a small part of the lesser trochanter is visible medially
anterior and posterior margins of the femoral condyles should be superimposed
Practical points
Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still when their affected leg is moved onto the detector.
Immobilization techniques
It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.
it may be necessary for the parent or radiographer to hold the patient or use sandbags to keep the leg in position
ideally the parent should be in the child's direct line of sight
techniques will vary based on the department
distraction techniques can be utilized to avoid scattered radiation to parents and staff 3