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Hips positioning influences official evaluation.
Quality of the image on the x ray film is paramount for the proper and highest level of results of the x-ray evaluation by the agency which evaluates the hip x-ray submitted to them (OFA). Please keep in mind that they will not "assume " that the hips are better then shown on poorly done x-ray. They will only read what they see. Thus it is important to stress to the vet that you are picky and maybe give him list which I made below. Your vet knows all the "stuff" but it will make him feel that you are more anal retentive then average client and will care more to perform better job. Tell him/her upfront(!) that you will make him/her re-do the x ray if it is not perfect. Remember you are the boss and vet is not god. X-rays are very expensive and you want to get what you are paying for.
I have on my website some pictures of well done x ray and poorly done x ray. Please look at it.
Anaesthetized or not
Most vets demand that the dog is anaesthetized for the x-rays. I recommend against it. OFA allows for that on the form. The dog is a little harder to position if it is not "under" but the hips will look worse. Some vets will demand to anaesthetized the dog in order to achieve by you demanded perfect positioning. I assure you that that is not necessary. I am x-raying dogs for 30 years and have never seen dog which needs to be anaesthetized. I have lost a dog to anesthesia and just will not do it unless in surgery where it is absolutely necessary but not for convenience of the veterinarian personnel.
Always keep in mind perfect picture of the x-ray.
1.Left side of the image must be exact mirror image of Right side.
    That is determined by:  a. the "holes" in the pelvis must be of exact size and shape.
                                      b. the overlap of the hipbone (femur) and pelvis must be of exact size and shape.
2.What must be parallel and what perpendicular.
   That is determined by:   a. the femurs must be parallel with each other.
                                      b. the femurs must be parallel with the spine
                                      c. the femurs must be parallel with the vertical ( up-down) axis of the pelvis
                                      d. Perpendicular ( 90* angle)  must be exact between horizontal (L and R) axes of the pelvis and femurs and spine.
3.What must be seen on the x-ray:
                                      a. top of the pelvis
                                      b. knee caps
4. Positioning of the kneecaps: Knee caps must be in the middle of the knee like in a bull's eye target. This is extremely important and most common mistake vets make and one of the most influential parts of the x-ray. If the knee caps are pointed outwards then that will torque out of the socket and make the hips look out of socket and make look the femoral neck thicker which will downgrade your OFA hips evaluation. 
X-Ray film quality.
1. Best x-ray machine is digital, but conventional x-ray can give you very good image, but conventional machines are harder to handle and require more skill.
2. Make sure that the picture has a black color and white color. If it is gray then the development technique is poor or the chemicals used for development and stabalization of the negative are            used up and old.
3. Make sure that the picture is in the "focus" (is not fuzzy) and edges of the bones are razor sharp.
X-rays examples:
1. Hip Position.
   This is a 99.9% perfect positioning of the hips. For educational purposes see that the dog is laying slightly more to the right side of the picture. But for practical purposes this is not significant.
2. Freeda: Almost perfectly taken x-ray. Kneecaps are pointing up everything is parallel and perpendicular.
  The film is done well but not perfect. Edges of the bones could be slightly sharper.
  Also take a look that the dog is laying slightly more on the right side which is obvious from the image of the spine being closer to the hole in the pelvis on the dog's right side (on the x-ray it is        on your left hand side).
  I would accept this x-ray.
3. hd2.jpeg This is an example of excellent digital film. L and R are exact mirror image of each other. but femurs are in LALA land and are not parallel.
4. Quality picture. This is well executed x-ray. 99% perfect. I placed it here in order to see that the knee caps are pointing out a little. Not a practical problem here though. The film is perfect, L R        symmetry is excellent. The hips themselves are not that good.
5. Poor hips positioning. This is exceptionally poor hips positioning in all aspects.
6. Poor hips positioning 2. This is and excellent negative film but positioning which some vets may ask you to accept and you must not.
   Kneecaps are pointing outwards, femurs are not parallel with pelvis and spine.
7. Gaston ready. Looks like good positioning right? Wrong !!!!  This is a subtle problem which is most dangerous because to the novice it is not too obvious.
   Here are the problems: No knee caps(!). L to R mirror image is good but the film negative is of poor quality it is all fuzzy. I would accept this for my orientation but I would most definitely not (!!!!!)     send this quality of a x-ray to OFA for official evaluation. The image like this may cost you 1 -3 degrees down especially if the hips have even slight problem. (Which these have not)
8. Yass jipo me. This dog is muddy! Wash your dog.
9. Zombie Hips. This is an example how dog with good hips will be downgraded by official evaluator if the hips are not positioned well.  This is also an example of positioning which you may be           offered to you to accept by the vet. I pesonally would refuse such x-ray especially if it is used for official evaluation!  This dog  got 1/1, but I firmly believe that it should be 0/0 if positioned                properly. Negative is of good quality.
   Bad is that the knee caps are torqued inwards thus the femoral necks look thicker and thus downgrade the evaluation. I have seen this being done in order to make hips look more in the                socket, but it will also make the necks of the femur look thicker, which is bad and will downgrade official evaluation at least one degree.  Pelvis spine unit is not parallel with femurs. That will          make the femur on the left look better and the one on the right worse. It is really hard to tell what the hip on the right would look like if it would be properly positioned.
   I personally would not accept this x-ray for OFA. With proper positioning the hips would probably look much better and they are already pretty good thus I personally would probably accept it         for my own reference.
10. Quint hronovsky pramen x-rays.  This is an x-ray of my stud Quint. Knee caps are pointing outwards a little which makes these very nice hips look a little worse. The top of the pelvis is not in         the picture. This dog has chance to get OFA excellent and thus I will re x-ray this dog for OFA evaluation.
How to environmentaly induce best possible hips:
Hip displasia is a polygenetic problem with irregular pattern:
What not to do:
a) Do not feed so called optimal high protein "balanced granulated dog food". Dogs then grow too fast=HD. Read the section on feeding.
  Make sure dog grows SLOWLY(!!!)
b) Do not put the pup through high shock, high stress exercises 1x per day is bad.
  However all day activity, moderate exercise is good.
c) Do not bother to x-ray dog's hips if they are limping in order to check if there is something wrong with pup's hips under 1 year. If the dog is limping at this age it is propbably caused by pano           probably caused by "balanced" granulated dog food, or it is a soft tissue injury . Your vet knows this and is just milking your $$$.
d) Do not bother to x-ray dogs hips in older dogs if they are limping. The "c" point above is also the truth about dogs younger then 6.  The problem in limping of old HD effected dogs is caused by       severe arthritis which does not show in that level until the dog is at least 6 but usually not less then 8 or 9 years.
e) Do not accept hips x-ray of improperly positioned dog. They are often completely useless for evaluation of hips. You are paying for properly positioned, properly exposed and properly developed      x-ray. Today digital x-rays are the best. Educate your self on proper positioning of the dog on HD x-ray.
f)  Do not send the x-rays to OFA before you send them to me for evaluation of point "e" above. Improperly done x-ray will diminish the degree of evaluation of the hips. It is possible to get                  dysplastic evaluation of technically improperly done x-ray which could be OFA good if the x-ray is done right.
g) Do not despair if the dog has bad hips. IT IS NOT A DEATH WARRANT!!!
  99% dogs live normal life with bad hips. I remember severely dysplastic 9 year old Search & Rescue dog "Samson" who was running long days in the mountains of Wyoming in deep snow             without any problem.
h) Do not get upset too soon. More then 50% of vets will give you improper evaluation of the hips, based on lack of knowledge, improper positioning, or with the idea that they will sell you a hip           replacement surgery for cost of a large luxury car.
i) Do not let the dog run too much up and down the stairs.
What to do:
a) Do not feed too much!!!!! 
b) Make sure the dog is skinny.(See his last 2 ribs).
c) Swimming is great.
d) Moderate prolonged exercise. (often but not shocky like jumping, playing Frisbee and so on.,)
e) Sunshine is the best source of vitamin "D" => facilitates proper bone creation(Opposite of rickets).
f)  Raw veggies blended into food and great source of natural = bio-available source of minerals, vitamin "C" ( facilitates mineral digestion) and enzymes.
g) Boil soup bones feed the soup and use the bones as toys.
What to feed.
Feed the pup/ dog MEAT. There is no substitute for meat. Meat is the highest quality of food for your pup/dog. Even the best commercial granulated food is crap compared to that. Feed this diet all their life there is no difference in nature in puppy food or senior food.
Recipe: Chicken meat with flat bones and all of the cartilage. Cook the meat with pasta, and add a pinch of sea salt. Also add into it 1 blended tablespoon of raw parsley and carrots, live greek yogurt or kiefer and fish oil. Meat should be only LIGHTLY cooked. Boil marrow soup bones. Bone marrow is a great stuff for pups/dogs. Remaining bones are great CHEW TOYS. soup is great for bones and joints. Cooked chicken feet, turkey necks and pigs feet (available in Chinese and Mexican supermarkets) is also great! = High content of Glucosomine, Chondroitin, MSM, and Hyluronic acid (Joint builders).
I also recommend live yogurt or live kefir(Greek yogurt, goat milk yogurt) with live culture mix into the food about 1 table spoon per dog/pup. You can make your own. You must use organic milk ( Cow is OK but best is goat milk) into which you mix live kefir ( I use Lifeway Greek kefir; ) which you can buy in heath feed store or kiefer "grains" available on Internet:
No commercial dog food can measure up to Meat. Meat is the most perfect balanced food.  Feed different meats.
Do not supplement the dog! Dog then grows too fast and that causes Pano and BAD HIPS!!!!
Make sure dog grows SLOWLY(!!!)
In nature dogs/ wolfs eat bugs, berries and rodents, and often nothing. Dogs are not designed for optimum diet at all the time. Keep the pup skinny and growing slowly.!
So called high quality high protein dog food is not so good for the dogs.
If your dog is lacking in some nutrition then rather then looking for a supplement from a bottle look for a natural source of it.
Minerals: Meat lightly cooked, raw blended vegetables, sea salt.
Vitamins: Meat lightly cooked, raw blended vegetables.
Enzymes: Meat lightly cooked, raw blended vegetables.
Amino acids: Meat
( Vegetables use about 1-2 tablespoons of raw , fresh, blended veggies per day. SOME VEGETABLES MAY BE POISONOUS TO DOGS. Always check. Carrots, Apples, Pinapple, Parsley are good. )
One more time:
" Meat is the best supplement!"
Any supplementation on top of proper diet described here is
over-supplementation which may have permanent damaging effects on hips and hormonal balance.
I hope all this will help you if you have any more questions please let me know
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