Objective-To describe CT image reconstruction criteria for measurement of the tibial tuberosity-trochlear groove (TT-TG) offset distance, evaluate intra- and inter-reconstruction repeatability, and identify key sources of error in the measurement technique, as determined in vulpine hind limbs. Animals-12 red fox (Vulpes vulpes) cadavers. Procedures-CT images of each hind limb in intact cadavers were obtained; at 1-week intervals, 3 reconstructions were performed that were based on 1 plane passing through the centers of the femoral head and medial condyle and parallel to the caudal femoral condyles, 1 plane aligned with the femoral trochlea, and a third orthogonal plane. Randomized and anonymized reconstructions were assessed for TT-TG offset distance with a single-image technique by 1 observer, and inter-reconstruction repeatability and intra- and inter-reconstruction measurement repeatability were assessed via the repeatability coefficient and intraclass correlation coefficient. Results-Multiplanar reconstructions of hind limb images were repeatedly made to within a few degrees of each other. Intra- and inter-reconstruction repeatability for TT-TG offset distance measurement was good. Repeatability was most affected by accurate identification of the tibial tuberosity and femoral trochlea landmarks. Conclusions and Clinical Relevance-Results obtained from vulpine hind limb CT images indicated that reconstructions can be made with a high degree of repeatability when based on strictly defined and applied criteria. The TT-TG offset distance has potential as an objective assessment of alignment of the distal portion of the quadriceps mechanism; its use as an aid in case selection for corrective femoral osteotomy among dogs with medial patellar luxation warrants investigation.