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This article presents common methods for calculating the scaling factor in X-ray images and reveals their basic technical difficulties, accuracy and error sources. Further, the causes for magnification of patient anatomy in X-ray images are described. Preoperative planning by means of X-ray images, its difficulties, reliability and limitations are also illustrated. Additionally, a new approach is introduced which is based on a stereo camera system used to identify the magnification especially in anterior-posterior pelvis images for hip application, considering the geometry of X-ray apparatus while minimizing errors by foreclosing the well-known central issues of all the conventional methods for the most part.

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Methods to determine the scaling factor in X-ray images for exact preoperative planning in hip surgery: A comparison of existing methods and introduction to a new approach