It allows analyzing the most anterior and posterior aspects of the joint space that are not depicted on the AP and the other lateral radiographs, at the expense of a decrease in the overall quality of the image. The off-lateral view (also called false profile of Lequesne) is a unique radiograph that provides an evaluation of the hip joint in a near sagittal plane, with the femur in an anatomic position ( Fig. 4 ). Most of the lateral radiographs are obtained with different degrees of hip abduction and flexion providing a lateral view of the proximal femur. Several different lateral views of the hip can be obtained, the choice of which may depend on the clinical situation ( Fig. 3, Table 1 ). In the authors’ institution, an AP hip radiograph usually is obtained because of the high quality of the bony details secondary to beam collimation. The added value of an AP hip radiograph to complement pelvic radiograph is open to debate except after total hip replacement. Standing hip radiograph does not provide additional information on the joint space except in severe hip dysplasias, opposite to the knee joint, for which proper assessment of the joint space width requires weight-bearing radiographs. When obtained in a standing position, it enables detecting leg length discrepancy but provides a less satisfactory analysis of the bone structure. The AP pelvic radiograph should be obtained with the patient lying supine, the lower limbs medially rotated (20 degrees). Moreover, by allowing the comparative analysis of both hips, it enhances the detection of subtle bone and joint abnormalities. The pelvic radiograph allows the assessment of the entire pelvic girdle, providing an overview of the entire region.

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Normal hip joint anatomy xray