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Diagnostic Radiographer study materials
Diagnostic Radiographer study resources

Diagnostic Radiographer: Radiographic Procedures and Positioning

Diagnostic Radiographer · Work through your exam, one topic at a time.

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Radiographic Procedures and Positioning

This domain tests whether you can position a patient reproducibly, choose the right projection for the clinical question, and recognize when an image will not demonstrate the anatomy. Items often describe a patient condition and ask for the correct projection or the error visible on the image.

Terminology and landmarks

  • Supine, prone, decubitus (lying on a side with a horizontal beam), Trendelenburg (head down), Fowler (head up).
  • Palpable landmarks: vertebra prominens C7, jugular notch T2-T3, xiphoid T9-T10, umbilicus L3-L4, iliac crest L4, anterior superior iliac spine S1-S2, pubic symphysis, greater trochanter.
  • Standard SID is 100 cm (40 in) for most examinations; PA chest uses 180 cm (72 in) to limit cardiac magnification.

Rules that earn marks

  • Include the joint above and the joint below a long bone.
  • Obtain at least two views at 90 degrees for fractures and dislocations.
  • Collimate to the anatomy of interest and shield gonads when shielding does not obscure diagnostic information.
  • Place a marker showing the anatomic side; it must be visible on the image.
  • Chest: PA upright at 72 in, shoulders rotated forward to clear the scapulae, chin elevated, exposure at full inspiration.
  • Abdomen: supine AP (KUB), exposure at end of expiration; an acute series adds upright and decubitus views for free air and fluid levels.
  • Spine: AP and lateral routinely; 45-degree obliques open the intervertebral foramina in the lumbar spine and the facets in the cervical spine.

Worked example

A trauma patient has a suspected left hip fracture. The correct study is an AP pelvis plus a cross-table (horizontal-beam) lateral of the left hip, not a frog-leg lateral. Reasoning: flexion and abduction can displace a femoral neck fracture, so the leg must not be moved; the horizontal beam produces a lateral projection without repositioning the limb.

Traps

  • Rotating a patient for a lateral when a decubitus with a horizontal beam is required.
  • Cutting off the joint above or below the injury.
  • Using 40 in SID for a PA chest, which magnifies the heart.
  • Omitting the side marker or placing it after processing.
  • Failing to remove radiopaque objects that mimic pathology.