A both heel lateral view X‑ray is a side‑profile radiograph of both heels taken to evaluate the calcaneus, subtalar joint, and surrounding soft tissues. It shows bone alignment, fractures, heel spurs, and calcaneal height. Typically obtained with each foot positioned laterally against the detector (standing or lying), it helps diagnose trauma, degenerative changes, and causes of heel pain.

The left lateral position places the patient’s left side against the image receptor so the X‑ray beam passes from right to left. It’s used for lateral chest or abdominal views and left lateral decubitus films to reveal pleural effusions, air–fluid levels, or to localize lesions. Proper positioning and side markers ensure accurate anatomy alignment and correct interpretation.

The lateral calcaneus projection is obtained with the patient in lateral recumbent position, affected side down, knee flexed and the ankle dorsiflexed to 90°. The foot is placed true lateral on the image receptor. The central ray is directed perpendicular to the IR, centered at the subtalar region—about 1 cm inferior to the medial malleolus—ensuring the entire calcaneus and subtalar joint are included.

The lateral aspect of the heel is the outer side of the heel over the lateral calcaneus. It includes skin, subcutaneous fat pad, lateral plantar fascia, and peroneal tendons that pass behind the fibula. This area can be affected by conditions such as lateral plantar fasciitis, peroneal tendonitis, calcaneal stress fracture, bursitis, or cuboid syndrome, causing localized pain and swelling.

A heel X-ray visualizes the calcaneus and surrounding bone structures, showing fractures, bone spurs, alignment and joint-space abnormalities (subtalar and calcaneocuboid joints). It can detect degenerative changes, bone infections, tumors, foreign bodies and calcaneal density differences. While soft-tissue conditions like plantar fasciitis aren’t directly seen, associated bony findings (heel spurs) and structural causes of heel pain are identifiable.

The difference is which side of the patient is placed nearest the image receptor. In a right lateral view the patient's right side is closest to the detector; in a left lateral view the patient's left side is nearest. Structures nearer the detector appear sharper and less magnified, so the chosen lateral view improves visualization and localization of pathology on the corresponding hemithorax or organ.