Leg length discrepancies, especially small ones, can only be accurately diagnosed with medical imaging. Both x-rays and CT scans have been demonstrated to be highly accurate. We at Accuthotix are recommending that you use the method that involves x-raying the patient in a standing position with the central ray passing through the femoral heads. Of course it is essential to make sure that your floor is level. This split view of the pelvis and lumbar spine is used to measure the heights of the femoral heads. If the femoral head heights differ more than 5mm and the spine deviates towards the short leg side, then a heel lift is recommended. The size of the heel lift should begin at 33% of the femoral head height difference. The Doctor can decide whether to use heel lifts, or to have the orthotics fabricated with a heel lift. Children should not have the heel lift fabricated to the orthotic because they may grow out of the short leg syndrome. You can read more about heel lift therapy under Short Leg Syndrome.