Hip - Axiolateral (Clements-Nakayama)

Adult

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Name of projection	Hip - Axiolateral (Clements-Nakayama)
Area Covered	Hip and proximal femur
Pathology shown	Fractures, dislocation
Radiographic Anatomy	Hip Radiographic Anatomy
IR Size & Orientation	24 x 30 cm Landscape
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	Decubitus filter may be used for film Not required with CR / DR
Exposure	80 kVp 40 mAs
FFD / SID	100cm
Central Ray	CR angled 15° posterior, perpendicular to the femoral neck
Collimation	Four sides of collimation Closely collimate to area of interest
Markers	Distal and Superior Marker orientation AP
Shielding	Gonadal shielding is not possible without obscuring essential anatomy (check your department's policy guidelines)
Respiration	Suspended
Positioning	Patient supine on the table, arms across upper chest Cushion for patients head The leg is not internally rotated as in other hip views but remains in a neutral or slightly externally rotated position (the CR is angled 15° posterior instead of the leg being internally rotated) Place IR in crease above iliac crest and adjust so that it is parrallel to femoral neck (use a dedicated cassette holder) Make sure IR is tilted 15° back to be perpendicular to CR to avoid grid cutoff CR angled 15° posterior, perpendicular to the femoral neck
Critique PACEMAN	Positioning Area Covered Collimation Exposure
Special Notes

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