Thigh Bone (Femur) X-ray (both sides)

What it is

This is a picture of the thigh bone itself — the long shaft between hip and knee, rather than either joint. Because a bone that thick rarely breaks without serious force, most of these films are taken after a motor vehicle or motorcycle crash, a fall from a height, or a gunshot wound; in older people whose bone has thinned, a simple fall can be enough. At least two projections are taken at right angles to each other, because a fracture that looks well aligned from the front can be badly angled when seen from the side. This code is the version covering both thighs. Two films of the same bone in different planes is the minimum any long-bone study needs; doing both legs gives a side-by-side comparison, which is used when the question is about length, rotation, or a difference between the two limbs rather than about an obvious break.

Why it is done

• To find and characterize a break in the shaft of the thigh bone after major trauma
• To show how the fragments are angled, shortened, or rotated, which decides the operation
• To compare the two thigh bones for length or shape, including in children being followed for a limb-length difference
• To check the position of a rod, plate, or screws after surgical fixation, and to follow the bone as it knits
• To look at bone that has been weakened by a tumour or by thinning, where a break can happen with little force

What to expect

The patient lies on the table and the technologist positions the leg for each exposure, sometimes using a long plate so the whole bone fits on one image. With a fresh femur fracture this is genuinely painful, and in a trauma bay the films are often taken with a portable machine while the leg is splinted, rather than by moving the patient to the x-ray department. Each exposure takes seconds. A CT is sometimes added when the break runs into the hip or the knee, or when a subtle fracture line is suspected but not seen. A radiologist reads and reports the images.

Questions worth asking

• Were both thighs actually filmed? A one-sided femur study is a separate, lower-priced code.
• If these were taken portably in a trauma bay or at the bedside, is there an added charge for portable equipment?
• Were the hip and the knee also filmed as their own studies? Adjacent joints are frequently imaged alongside a femur, and each is billed on its own.
• After surgery, are the follow-up films part of the surgeon's global fee or billed separately each visit?