What is the typical patient position for a lateral sacrum image?

• A. Lateral position with patient in a true lateral decubitus or standing/sitting lateral as needed.
• B. Supine with legs extended.
• C. Prone with pelvis rotated 30 degrees.
• D. Supine with knees flexed.

Answer: (A)

To image the sacrum in true profile, the patient needs a lateral orientation with no rotation of the pelvis. That means a true lateral position, either as a lateral decubitus (patient lying on their side) or a standing/sitting lateral if the patient can be upright. This alignment prevents the hips and pelvis from overlapping the sacrum and ensures the sacral anatomy is seen in full, without distortion. Other positions—supine, prone with pelvic rotation, or supine with knees flexed—don’t provide a true lateral view and would obscure or distort the sacrum.