If the distal femur is overexposed, a filter may be required. The radiograph has a uniform exposure throughout, evident by the fine bony detail and no areas of overexposure. patients that lack bone density require a compensating filter over the inferior aspect of the femur to allow even distribution of exposure, whilst patients with increased adipose tissue may not need a filter as the adipose tissue does a sufficient amount. ![]() a grid can be used, although it is not uncommon to utilize an air gap technique to achieve similar results.inferosuperior 12 cm each direction from the centering point.anteroposterior 9 cm each direction from the midline.the technical centering point is 13 cm distal to the neck of femur, anecdotally known as centering at the most superior region of the groin.the central ray is angled perpendicular to the long axis of the neck of femur the image receptor should be adjusted to match this angle.axiolateral (inferosuperior) projection.the flexed leg is placed on a dedicated stand this is incredibly uncomfortable for the patient the leg should only be up for a limited amount of time.the patient's unaffected hip can now be flexed and abducted.elevate the bed/trolley until the central ray is at the level of mid-thigh of the unaffected leg.This will ensure adequate centering in the superior-inferior aspect of the projection place a finger on the anterior superior iliac spine of the affected side, ensure it is projected onto the superior third of the image receptor.the image receptor should be placed in a landscape orientation superior to the iliac crest, allowing for adequate imaging of the femoral neck.the image receptor is angled approximately 20-45° to match the angle of the neck of femur (observed on the AP pelvis/hip) this is done to prevent elongation or foreshortening of anatomy.the image receptor can be an upright detector or a portable detector in an upright stand.the patient is supine with both arms on the chest, the side in question is closest to the image receptor:.It requires minimal patient movement on the affected side while providing high-quality diagnostic images that can be replicated both intraoperatively and postoperatively 1, 3. ![]()
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