X Ray Both Elbow Lateral View

A normal lateral elbow X‑ray shows the elbow flexed about 90°, with intact cortical margins and joint spaces, no fractures or dislocations. The anterior humeral line passes through the middle third of the capitellum and the radiocapitellar line runs through the centers of the radial head and capitellum. Fat pads are normal (no posterior fat pad or elevated anterior fat pad), and the olecranon aligns with the distal humerus.

For a perfect lateral elbow X‑ray, seat or stand the patient with the elbow flexed 90°, arm adducted and forearm in neutral rotation (thumb pointing up). Rest humerus and forearm on the same plane so medial and lateral epicondyles are superimposed. Center the beam at the elbow joint, include distal humerus and proximal forearm, remove jewelry, use a lead marker, and immobilize the limb to prevent motion.

The lateral (lat) view in X‑ray is a side‑on radiograph that shows depth and relationships of internal structures not seen on front‑to‑back views. It helps localize fractures, lesions, air or fluid levels, and evaluates spine, chest, skull, and joints. The patient stands, sits, or lies with the side against the detector while the X‑ray beam passes laterally through the body.

The standard elbow radiographic series includes AP and lateral views, often with an oblique if needed. For AP: patient seated or supine, arm extended, forearm supinated, humerus and forearm on the same plane, beam centered at the elbow joint. For lateral: elbow flexed 90°, forearm and humerus perpendicular, thumb pointing up to place the olecranon in profile; beam perpendicular to the joint.

Standard elbow X‑ray usually includes three views — anteroposterior (AP), lateral, and oblique — to evaluate bone alignment, joint spaces, and fractures. At least two orthogonal views may be obtained in some settings, but three views are preferred. Additional targeted views (e.g., radial head, external rotation, or stress views) are taken when specific injuries are suspected.

The primary special test for lateral elbow pain is Cozen’s test: with the elbow flexed 90°, the patient makes a fist, pronates the forearm, and radially deviates and extends the wrist while the examiner resists wrist extension; reproduction of pain at the lateral epicondyle is positive. Mill’s test (passive wrist flexion with elbow extension) and Maudsley’s test (resisted third‑finger extension) can corroborate findings.