How to Confirm a Leg Length Discrepancy: Imaging, Who to See, and What to Expect

Suspecting a Leg Length Discrepancy Is Not the Same as Knowing It

You know the signs, you suspect this could be what you have, now it's time to learn what is next and why.

This post covers the two main types of imaging used to confirm LLD, what each involves, what to expect from the process, and how to access it quickly and affordably — without waiting months for a specialist referral.

Why Self-Assessment Alone Isn't Enough

Self-calibration is a valuable first step. It can help you identify asymmetry, build awareness of how your body is compensating, and give you a rough sense of whether a discrepancy is present. Our Get Calibrated˚ guide is designed exactly for this purpose.

But self-assessment has hard limits. Soft tissue tension, postural habits, and measurement technique all introduce error. A functional LLD — caused by muscle imbalance or pelvic tilt — can mimic a structural one, and treating the wrong type with a lift can make things worse. Without imaging, you're working with an estimate.

That distinction matters enormously when you're calibrating a correction to the millimetre.

The Two Types of Imaging for LLD

There are two primary imaging options for confirming a leg length discrepancy. Which one is right for you depends on the complexity of your case and how much precision you need.
Getting both can be useful for getting a big picture understanding of not only your LLD measurement but also how your body has been compensating for it. In the founder of MESA's (Joshua Kasumovic) case, he found the standing X-ray showed him how his pelvis had tilted and his spine has curved to compensate for his 10mm discrepancy which also explained quite a few of his symptoms over the years.

Option 1: Full-Length Standing X-Ray

Option 2: CT Scanogram

Who to See: Skip the Referral Queue with Sesame Care*

The traditional route — GP referral to orthopaedic specialist, who then orders imaging — can take weeks or months. Many GPs are also unfamiliar with LLD as a driver of chronic musculoskeletal pain, which means you may face dismissal before you even get to imaging.

The faster, more direct route is using a service like Sesame Care — an online doctor platform that connects you with licensed physicians who can order imaging without requiring an in-person specialist visit. Sesame Care* works with RadiologyAssist to find the most affordable and fastest imaging options near you, often at a fraction of the cost of hospital-based imaging. (MESA recommends Sesame Care*, they are a time and cost effective option available nationwide in the USA).

Here's how it works in practice:

1. Book a short online consultation with a Sesame physician (Often same day)
2. The physician orders the appropriate imaging (X-ray or CT scanogram) based on your presentation
3. RadiologyAssist locates the nearest available facility and books your appointment
4. For X-rays, many locations are walk-in — you can go the same day
5. For CT scanograms, appointments are typically available within a week

The result: a confirmed, clinically ordered measurement in hand far sooner than the conventional pathway — and at a price that makes sense.

What to Ask For

Whether you go through Sesame Care* or another provider, the physician will determine if imaging is appropriate for your case. Typically this involves:

• A full-length standing bilateral lower extremity X-ray — for standard LLD confirmation.
• Or a CT scanogram of the lower extremities — for sub-millimetre precision or complex cases.

For X-rays, specify weight-bearing / standing where possible. Supine (lying down) X-rays do not capture the functional load distribution that affects your correction target.

Reading Your Results

Your imaging report will give you a measurement — in millimetres — of the length difference between your left and right legs, broken down by femur and tibia. This is your structural LLD.

A few things to keep in mind when interpreting it:

• Under 5mm — generally considered within normal variation, though symptomatic individuals may still benefit from correction
• 5–20mm — the range where a precision lift correction is most clearly indicated
• Over 20mm — typically warrants clinical involvement alongside any lift correction, MESA recommends you work with a clinician in these cases to ensure you are doing the right thing for your body as the adjustment is significant.

Once you have your number, you have everything you need to begin a structured correction.

What Comes Next

Imaging gives you the measurement. What you do with it determines whether your symptoms actually resolve.

The MESA HexLift™ system is built for exactly this moment — a precision, modular lift that lets you start at a conservative correction height and gradually increment upward as your body adapts, without ever losing accuracy.

With a HexLift™ full foot lift or HexHeel™ heel lift option, you can select which product best suits your needs. For LLD, especially starting off with, a full foot lift is more commonly used as it tends to keep the body more biomechanically correct, putting less strain on other parts of the body such as the calf muscles and Achilles tendon.

The HexCore™ lattice holds its height under load, so the correction you dial in is the correction you're actually getting for years to come. Better yet, the HexLift™ foot lifts have been designed with active lifestyles in mind so a lift won't stop you doing the things you love.

If you are new to using lifts, MESA recommends the starting framework below.

If you haven't yet done a self-assessment, start there. If you have — and the signs point to a real discrepancy — imaging is your next step. It's faster and more accessible than most people expect.

*MESA has a paid partnership with Sesame Care and may earn a commission if you book through this link.