A surgical device having an assembly used to position a patient-specific surgical instrument with a bone of a patient, the assembly having radio-opaque and radiolucent portions that provide an indication of the instrument, and corresponding implant's alignment with respect to the bone, as well as an indication that the angle of the projection (or orientation of the view) of the alignment guide to assess the placement of the alignment guide relative to the underlying bony anatomy. The radio-opaque portion may include a plurality of Kirschner wires, fiducial markers, and may include a void allowing for alignment down a first length of the radio-opaque portion. Embodiments may be used with intra-operative fluoroscopy.