X-Ray / Radiography

Global Radiography Academy

Welcome to the comprehensive X-Ray / Radiography resource centre. From fundamental principles and routine positioning to trauma, mobile, theatre, fluoroscopy and paediatric radiography, this section covers the core knowledge a radiographer needs across everyday and specialised practice.

X-Ray Fundamentals

Radiography uses ionising X-rays to produce diagnostic images of anatomical structures. High-quality radiography requires an understanding of X-ray production, equipment, exposure factors, positioning, image quality, digital image acquisition and radiation protection.

The radiographer's objective is to obtain a diagnostic-quality image with the minimum radiation exposure reasonably achievable, while maintaining patient safety, comfort and dignity.

1. X-Ray Equipment & Components

1.1 X-Ray Tube

The X-ray tube produces X-rays by accelerating electrons from the cathode towards the anode.

Main components:

  • Cathode — Filament, Focusing cup
  • Anode — Target, Rotating anode in most diagnostic systems
  • Tube housing
  • Glass / metal envelope
  • Protective shielding

Important concepts:

  • Thermionic emission: release of electrons from the heated filament.
  • Tube current (mA): controls the quantity of electrons flowing across the tube.
  • Tube voltage (kVp): determines the potential difference across the tube and influences photon energy and beam penetration.

Most of the electron energy is converted into heat at the target, with only a small proportion converted into X-rays.

1.2 X-Ray Generator

The generator supplies and controls electrical power to the X-ray tube.

Important generator functions include:

  • kVp selection
  • mA selection
  • Exposure time
  • mAs
  • Exposure control
  • AEC where available

Modern generators may use high-frequency technology to provide consistent and accurately controlled exposures.

1.3 Collimator

The collimator restricts the X-ray beam to the required anatomical area.

Functions:

  • Reduces unnecessary radiation exposure
  • Reduces scatter radiation
  • Improves image quality
  • Helps demonstrate the anatomy of interest
  • Reduces radiation dose to the patient

The radiation field should be appropriately restricted without excluding clinically required anatomy.

1.4 Image Receptors / Detectors

Computed Radiography (CR) — Uses a photostimulable phosphor imaging plate which is subsequently processed by a reader.

Digital Radiography (DR) — Uses an electronic detector to acquire the image directly.

Advantages of digital imaging include:

  • Rapid image availability
  • Wide exposure latitude
  • Image processing
  • Electronic storage
  • PACS integration

Digital systems can tolerate a wider range of exposures than film-screen systems, but this must not lead to unnecessary increases in patient dose.

1.5 Grids

A radiographic grid is positioned between the patient and detector to absorb a proportion of scattered radiation before it reaches the detector.

Advantages:

  • Reduces scatter reaching the detector
  • Improves image contrast

Considerations:

  • Requires increased exposure
  • Can increase patient dose if technique is not appropriately adjusted
  • Requires correct alignment
  • Grid selection depends on examination, patient thickness and equipment

A grid should be used when clinically appropriate and according to departmental protocol.

1.6 Automatic Exposure Control (AEC)

AEC automatically terminates the exposure when a sufficient amount of radiation reaches the detector.

AEC can help provide consistent receptor exposure, but correct:

  • Patient positioning
  • Chamber selection
  • Collimation
  • Anatomical coverage
  • Patient size

are essential for reliable results.

Exposure & Technical Factors

Selecting appropriate exposure factors is central to producing diagnostic-quality radiographs while keeping patient dose as low as reasonably achievable.

2.1 kVp

Kilovoltage peak (kVp) determines the maximum energy of photons produced and strongly influences beam penetration.

Increasing kVp generally:

  • Increases beam energy
  • Increases penetration
  • Can reduce subject contrast
  • Increases detector exposure if other factors remain unchanged

The appropriate kVp depends on:

  • Anatomical region
  • Patient size
  • Examination
  • Detector system
  • Grid use
  • Equipment
  • Local technique chart

2.2 mAs

mAs = mA × exposure time

mAs primarily controls the quantity of X-rays produced.

Increasing mAs generally:

  • Increases the number of photons
  • Increases receptor exposure
  • Increases patient radiation dose

mAs should be sufficient to obtain a diagnostic image while avoiding unnecessary exposure.

2.3 Exposure Time

Short exposure times help reduce motion blur.

This is particularly important for:

  • Chest radiography
  • Trauma
  • Paediatric imaging
  • Patients who cannot cooperate
  • Portable radiography

Where possible, use an appropriate short exposure time while maintaining adequate image quality.

2.4 SID

Source-to-image distance (SID) is the distance between the focal spot of the X-ray tube and the image receptor.

SID affects:

  • Magnification
  • Geometric sharpness
  • Radiation intensity at the detector

A longer SID generally reduces magnification when other geometric factors remain constant.

Chest radiography commonly uses a longer SID, often around 180 cm, to reduce cardiac magnification.

2.5 OID

Object-to-image distance (OID) is the distance between the anatomical part and the image receptor.

Increasing OID generally:

  • Increases magnification
  • Increases geometric unsharpness

Where possible, position the anatomical part close to the detector.

2.6 Focal Spot

The focal spot is the area of the anode target from which X-rays are produced.

Small focal spot:

  • Better spatial resolution
  • Less geometric unsharpness
  • Lower tube loading capability

Large focal spot:

  • Allows higher tube loading
  • Greater heat capacity
  • More geometric unsharpness

The smallest appropriate focal spot should be selected when practical.

2.7 Inverse Square Law

X-ray intensity varies inversely with the square of the distance from the source.

I₁ / I₂ = (D₂ / D₁)²

Therefore, increasing distance from the X-ray source substantially reduces radiation intensity.

This principle is important for:

  • Exposure calculations
  • SID selection
  • Radiation protection
  • Mobile radiography

Radiographic Positioning Principles

Accurate positioning is the foundation of diagnostic radiography. This section covers anatomical position, body planes, patient positions, radiographic projections and central ray principles.

3.1 Anatomical Position

The standard anatomical position provides a consistent reference for describing patient positioning and anatomical relationships.

3.2 Body Planes

  • Sagittal plane
  • Coronal plane
  • Transverse / axial plane

3.3 Common Patient Positions

  • Erect
  • Supine
  • Prone
  • Seated
  • Recumbent
  • Lateral
  • Oblique
  • Decubitus

3.4 Projection Terminology

The projection describes the direction of the X-ray beam through the patient.

Examples:

  • AP
  • PA
  • Lateral
  • Oblique
  • Axial

Important: A projection describes the direction of the X-ray beam; it is not simply the same as the patient's position.

3.5 Central Ray

The central ray is the central portion of the X-ray beam used for positioning and centring.

Correct centring is essential to:

  • Demonstrate the required anatomy
  • Avoid unnecessary distortion
  • Ensure appropriate collimation
  • Produce reproducible images

Radiographic Image Quality

Image quality is determined by several interacting factors. Understanding each factor and its relationship to exposure technique is essential for producing diagnostic-quality radiographs.

4.1 Contrast

The difference in radiographic appearance between adjacent structures.

It is influenced by:

  • kVp
  • Subject characteristics
  • Scatter
  • Processing

4.2 Spatial Resolution

The ability to distinguish small or closely spaced structures.

Influenced by:

  • Focal spot size
  • OID
  • SID
  • Detector characteristics
  • Motion

4.3 Noise

Unwanted variation that can obscure anatomical detail.

Quantum noise is strongly influenced by the number of X-ray photons reaching the detector.

4.4 Distortion

Distortion occurs when the recorded size or shape of anatomy differs from its true form.

It is influenced by:

  • Object position
  • SID
  • OID
  • Beam angulation
  • Anatomical alignment

4.5 Motion

Patient or equipment movement during exposure produces image unsharpness.

Minimise motion by:

  • Explaining the examination
  • Appropriate immobilisation
  • Using suitable exposure times
  • Giving clear breathing instructions

Digital Radiography

Digital radiography provides a broad exposure latitude and allows post-processing of images. However, exposure optimisation remains essential — digital convenience must never lead to unnecessary patient dose.

5.1 CR and DR

Digital radiography provides a broad exposure latitude and allows post-processing of images.

Image appearance can be corrected digitally, but excessive radiation exposure cannot be removed from the patient.

Therefore, exposure optimisation remains essential.

5.2 Exposure Index

Many digital systems provide an exposure indicator / index to help assess detector exposure.

The exact index and target range vary between manufacturers.

Radiographers should follow:

  • Manufacturer guidance
  • Equipment-specific protocols
  • Local departmental exposure targets

5.3 Image Processing

Digital images can be processed to adjust:

  • Brightness
  • Contrast
  • Edge enhancement
  • Image appearance

Image processing should enhance diagnostic information and must not be used to compensate routinely for poor positioning or inappropriate exposure.

5.4 Common Digital Artefacts

Examples include:

  • Detector artefacts
  • Dead pixels
  • Processing artefacts
  • Grid artefacts
  • Motion
  • Foreign objects
  • Exposure-related artefacts

Radiation Protection & Dose Optimisation

Radiography must follow the principles of justification and optimisation.

6.1 ALARA

Radiation exposure should be kept As Low As Reasonably Achievable, while obtaining the required diagnostic information.

6.2 Patient Protection

Key measures include:

  • Confirm the correct patient
  • Confirm the examination
  • Use appropriate exposure factors
  • Accurate positioning
  • Appropriate collimation
  • Avoid unnecessary repeats
  • Use appropriate shielding in accordance with current local policy
  • Optimise exposure for patient size and examination

6.3 Staff Protection

The fundamental principles are:

Time — Minimise time exposed to radiation.

Distance — Increase distance from the radiation source whenever practical.

Shielding — Use structural or personal protective shielding where appropriate.

During mobile radiography, staff should maximise distance and use appropriate shielding / positioning.

6.4 Justification

Every radiographic examination should have an appropriate clinical indication and be justified according to applicable professional and regulatory requirements.

Patient Safety & Image Optimisation

Radiography is not simply the production of an image. The radiographer must balance:

Patient condition + Clinical question + Image quality + Radiation dose + Patient safety

Important principles include:

  • Correct patient identification
  • Appropriate examination verification
  • Clear communication
  • Respect for privacy and dignity
  • Safe patient movement and transfer
  • Infection prevention
  • Recognition of patient limitations
  • Appropriate immobilisation
  • Avoidance of unnecessary movement in trauma
  • Evaluation of every image before completing the examination

The radiographer should adapt technique when the patient's condition prevents an ideal standard projection.

Key Principles to Remember

The radiographer should always consider:

  • 1. Why? What is the clinical indication?
  • 2. Who? Is this the correct patient and examination?
  • 3. How? What positioning and technique are required?
  • 4. How much? What exposure is appropriate for this patient and examination?
  • 5. Is it good enough? Does the image meet diagnostic-quality criteria?
  • 6. Is it safe? Have patient and staff radiation protection requirements been met?

Core principle: The goal of radiography is not simply to produce an image; it is to produce the required diagnostic information safely, efficiently and with appropriate radiation exposure.

Quick Reference — X-Ray Fundamentals

A high-level one-glance summary of the key points across X-Ray Fundamentals.

Area Key Point
X-ray tubeConverts electron energy into X-rays; most energy becomes heat
kVpPrimarily controls beam energy / penetration
mAsPrimarily controls X-ray quantity
SIDSource-to-image distance; affects magnification and intensity
OIDObject-to-image distance; affects magnification and unsharpness
Focal spotSmaller focal spot generally improves spatial resolution
GridReduces scatter reaching detector but requires increased exposure
AECTerminates exposure when adequate detector exposure is reached
CollimationRestricts beam, reduces scatter and unnecessary exposure
PositioningCorrect patient and part positioning is essential for diagnostic imaging
Image qualityIncludes contrast, resolution, noise, distortion and motion
Digital imagingWide exposure latitude does not justify excessive exposure
Radiation protectionJustification, optimisation and ALARA
Patient safetyCorrect identification, communication, positioning and safe movement
Image evaluationEvery image should be assessed before completing the examination

Typical exposure values are illustrative. Equipment-specific technique charts, manufacturer recommendations, local protocols and applicable regulations should be followed.

References & Further Reading

The Global Radiographers X-Ray section uses a mixture of international regulatory / professional guidance, WHO / IAEA resources, professional curricula and established radiography textbooks. Textbook references support educational content, while current regulatory / professional guidance takes precedence for safety and practice requirements.

No. Reference / Topic Link
1WHO – Manual of Diagnostic Imaging: Radiographic Technique and Projections — positioning, projections and radiographic techniqueWHO Radiographic Technique →
2WHO / ISRRT – Quality Assurance Workbook for Radiographers and Radiological Technologists — image quality, QA and optimisationWHO QA Workbook →
3ASRT – Radiography Curriculum — professional educational framework and core radiography knowledgeASRT Curriculum →
4ASRT – Practice Standards for Medical Imaging and Radiation Therapy — professional practice, patient safety, positioning and radiation protectionASRT Practice Standards →
5IAEA – Radiation Protection of Patients — patient radiation protection and optimisation in medical imagingIAEA RPOP →
6European Commission – Radiation Protection / Medical Exposure guidance — European principles and recommendations for medical exposureEC Radiation Protection →
7Merrill's Atlas of Radiographic Positioning and Procedures — established reference for positioning, projections and radiographic proceduresElsevier – Merrill's →
8Bontrager's Textbook of Radiographic Positioning and Related Anatomy — positioning, anatomy and image evaluationElsevier – Bontrager's →
9Clark's Positioning in Radiography — radiographic positioning, technique and clinical applicationsElsevier – Clark's →
10WHO – Quality Systems for Medical Imaging — quality management, imaging standards and service qualityWHO Quality Systems →

References are supporting sources rather than the focus of the page. For technical parameters, especially exposure factors, typical values are illustrative — equipment-specific technique charts, manufacturer recommendations, local protocols and applicable regulations should be followed.

Routine Radiography — Head & Neck

This section covers routine radiographic examinations of the skull, facial bones, paranasal sinuses and cervical spine. Each examination will follow the standard 8-section format covering overview, clinical indications, positioning, technique, evaluation criteria, modifications, radiation protection and quick reference.

Content under development

Skull

  • AP / PA skull
  • Lateral skull

Facial Bones

  • Facial bones
  • Orbits
  • Nasal bones
  • Mandible
  • TMJ

Paranasal Sinuses

  • Routine sinus projections

Cervical Spine

  • AP
  • Lateral
  • Open-mouth / odontoid
  • Oblique
  • Cervicothoracic / cervicodorsal spine

Routine Radiography — Chest & Thorax

Chest radiography is one of the most frequently performed radiographic examinations. This section covers standard and specialised chest projections along with ribs and sternum imaging.

Content under development

Topic Areas

  • PA chest
  • Lateral chest
  • AP chest
  • Supine chest
  • Apical / lordotic chest
  • Expiratory chest
  • Decubitus chest
  • Ribs
  • Sternum

Routine Radiography — Abdomen

Abdominal radiography includes supine, erect and decubitus projections along with the KUB and acute abdomen series. This section covers the routine abdominal examinations used in clinical practice.

Content under development

Topic Areas

  • AP supine abdomen
  • Erect abdomen
  • Decubitus abdomen
  • KUB
  • Acute abdomen series
  • Other established routine abdominal projections

Routine Radiography — Upper Limb

Upper limb radiography encompasses examinations from the fingers and hand through the wrist, forearm, elbow, humerus and shoulder girdle. This section covers all routine upper limb projections.

Content under development

Fingers & Hand

  • Fingers
  • Thumb
  • Hand

Wrist

  • Wrist
  • Scaphoid

Forearm & Elbow

  • Forearm
  • Elbow
  • Radial head
  • Olecranon

Humerus

  • AP
  • Lateral

Shoulder

  • Shoulder
  • Clavicle
  • Scapula
  • AC joints

Routine Radiography — Lower Limb

Lower limb radiography covers examinations from the toes and foot through the ankle, tibia and fibula, knee, femur, hip and pelvis. This section covers all routine lower limb projections.

Content under development

Foot & Toes

  • Toes
  • Foot
  • Calcaneus

Ankle

  • AP
  • Lateral
  • Mortise

Tibia & Fibula

  • AP
  • Lateral

Knee

  • AP
  • Lateral
  • Oblique
  • Patella

Femur

  • AP
  • Lateral

Hip

  • AP hip
  • Lateral hip
  • Cross-table lateral

Pelvis

  • AP pelvis

Routine Radiography — Spine

Spinal radiography requires careful attention to positioning and radiation protection. This section covers routine projections of the cervical, thoracic, thoracolumbar, lumbar, lumbosacral spine, sacrum and coccyx, and sacroiliac joints.

Content under development

Cervical Spine

  • AP
  • Lateral
  • Open-mouth / odontoid
  • Obliques
  • Cervicothoracic / cervicodorsal junction

Thoracic Spine

  • AP
  • Lateral

Thoracolumbar Spine

  • AP
  • Lateral
  • Thoracolumbar junction

Lumbar Spine

  • AP
  • Lateral
  • Obliques
  • L5-S1 spot / coned view where appropriate

Lumbosacral Spine

  • AP / axial
  • Lateral
  • L5-S1 spot / coned view
  • Other appropriate supplementary views

Sacrum & Coccyx

  • AP / axial
  • Lateral

Sacroiliac Joints

  • AP
  • Oblique projections

Special / Advanced Projections — Skull & Facial Bones

This section covers specialised projections of the skull and facial bones that are additional to routine examinations. Each projection will follow the standard 8-section format.

Content under development

Topic Areas

  • Caldwell
  • Waters
  • Towne
  • SMV (submentovertex)
  • Rhese (optic foramen)
  • Other established special projections

Special / Advanced Projections — Cervical / Thoracic Spine

Supplementary projections of the cervical and thoracic spine for situations where routine projections are insufficient.

Content under development

Topic Areas

  • Swimmer's
  • Flexion
  • Extension
  • Other supplementary projections

Special / Advanced Projections — Shoulder

Specialised shoulder projections for detailed assessment of the glenohumeral joint, AC joints and instability.

Content under development

Topic Areas

  • Grashey
  • Scapular Y
  • Axillary variations
  • Stryker notch
  • West Point
  • AC joint stress views

Special / Advanced Projections — Knee

Specialised knee projections for assessment of the patellofemoral joint, intercondylar notch and weight-bearing alignment.

Content under development

Topic Areas

  • Skyline / sunrise
  • Tunnel / intercondylar
  • Weight-bearing
  • Stress views

Special / Advanced Projections — Foot & Ankle

Specialised projections of the foot and ankle including weight-bearing and stress views.

Content under development

Topic Areas

  • Weight-bearing
  • Stress views
  • Special calcaneal projections

Orthopaedic / Measurement Studies

Specialised orthopaedic measurement studies used for alignment and limb-length assessment.

Content under development

Topic Areas

  • Long-leg alignment
  • Limb-length measurement
  • Other established specialised orthopaedic examinations

Other Special Projections

Additional internationally recognised special projections that have meaningful educational or clinical relevance. Obscure or historical projections without current clinical relevance are not included.

Content under development

Detailed content for additional special projections will be developed based on internationally recognised radiography references and current clinical practice.

Principles of Trauma Radiography

Trauma radiography requires adaptation of routine techniques to accommodate patient condition, immobilisation and clinical urgency. This module covers the guiding principles of trauma imaging.

Content under development

Topic Areas

  • Patient stability
  • Immobilisation
  • Avoiding unnecessary movement
  • Adaptation of routine projections
  • Working around casts and splints
  • Communication with clinical teams

Head & Facial Trauma

Radiographic imaging of head and facial trauma requires modified techniques adapted to the injured patient.

Content under development

Topic Areas

  • Skull trauma
  • Facial trauma
  • Mandibular trauma
  • Foreign-body imaging

Cervical Spine Trauma

Cervical spine trauma imaging is performed with strict spinal precautions. Horizontal-beam lateral and cross-table techniques are essential.

Content under development

Topic Areas

  • Immobilised patient
  • Horizontal-beam lateral
  • Cross-table techniques
  • Trauma modifications

Chest Trauma

Chest trauma imaging may require portable equipment and adapted positioning for suspected pneumothorax, haemothorax and rib injury.

Content under development

Topic Areas

  • Portable chest
  • Rib trauma
  • Pneumothorax-related imaging
  • Haemothorax-related imaging
  • Trauma positioning

Pelvis & Hip Trauma

Pelvic and hip trauma imaging requires careful handling to avoid worsening potential fractures. Cross-table lateral techniques are commonly used.

Content under development

Topic Areas

  • Pelvic trauma
  • Suspected hip fracture
  • Cross-table lateral
  • Avoiding unnecessary rotation

Upper & Lower Limb Trauma

Limb trauma imaging covers fractures, dislocations and imaging through casts and splints using adapted projections.

Content under development

Topic Areas

  • Fractures
  • Dislocations
  • Casts and splints
  • Adapted projections

Polytrauma

Polytrauma imaging involves rapid, coordinated acquisition across multiple body regions while maintaining spinal precautions and effective communication.

Content under development

Topic Areas

  • Emergency department imaging
  • Portable imaging
  • Multiple injuries
  • Spinal precautions
  • Workflow and communication

Emergency Imaging Considerations

Emergency imaging balances patient condition against ideal positioning. This module covers rapid acquisition, image quality decisions and radiation protection in the emergency context.

Content under development

Topic Areas

  • Rapid image acquisition
  • Patient condition versus ideal positioning
  • Image quality
  • Repeat decisions
  • Radiation protection

Mobile Radiography Fundamentals

Mobile radiography brings imaging to the patient. This module covers equipment preparation, detector handling, battery and power management, infection prevention, patient identification and communication in the mobile context.

Content under development

Topic Areas

  • Mobile X-ray equipment
  • Equipment preparation
  • Detector handling
  • Battery / power
  • Infection prevention
  • Patient identification
  • Communication

Ward Radiography

Ward radiography covers portable imaging of chest, abdomen, pelvis and extremities with the positioning limitations inherent to the ward environment.

Content under development

Topic Areas

  • Portable chest
  • Portable abdomen
  • Portable pelvis
  • Portable extremities
  • Positioning limitations

ICU Radiography

ICU radiography involves imaging critically ill, often ventilated patients with multiple lines and tubes. Image evaluation must account for supportive equipment.

Content under development

Topic Areas

  • Portable chest
  • Lines and tubes
  • Ventilated patients
  • Supine imaging
  • Image evaluation

Emergency Department

Portable trauma imaging in the emergency department requires rapid acquisition for unstable patients.

Content under development

Topic Areas

  • Portable trauma imaging
  • Unstable patients
  • Rapid imaging

Neonatal / Special Care

Neonatal and special care imaging requires careful attention to dose, positioning within incubators and assessment of lines and tubes.

Content under development

Topic Areas

  • Portable chest
  • Abdomen
  • Lines and tubes
  • Incubator imaging

Isolation / Infection-Control Situations

Imaging in isolation and infection-control situations requires equipment protection, decontamination procedures and adapted workflow.

Content under development

Topic Areas

  • Equipment protection
  • Cleaning / decontamination
  • Workflow

Mobile Radiation Protection

Radiation protection in mobile radiography requires careful staff positioning, distance, scatter management and awareness of other patients and clinical staff.

Content under development

Topic Areas

  • Staff positioning
  • Distance
  • Scatter
  • Other patients
  • Clinical staff
  • Mobile exposure precautions

Operating Theatre Environment

The operating theatre is a specialised environment with its own workflow, sterile field requirements and communication protocols. This module covers the radiographer's role and theatre fundamentals.

Content under development

Topic Areas

  • Radiographer's role
  • Theatre workflow
  • Sterile / non-sterile areas
  • Communication
  • Infection prevention
  • Equipment movement

Mobile X-Ray in Theatre

Mobile X-ray units are commonly used in theatre for intraoperative imaging. This module covers detector positioning, exposure considerations and radiation protection.

Content under development

Topic Areas

  • Mobile X-ray
  • Detector positioning
  • Exposure considerations
  • Radiation protection

C-Arm Radiography

C-arm fluoroscopy is widely used in orthopaedic and other surgical procedures. This module covers C-arm components, positioning, image acquisition and dose optimisation.

Content under development

Topic Areas

  • C-arm components
  • Positioning
  • AP
  • Lateral
  • Oblique
  • Image acquisition
  • Dose optimisation

Orthopaedic Procedures

Orthopaedic theatre imaging covers fracture fixation, plates and screws, intramedullary nails and joint procedures across upper and lower limbs.

Content under development

Topic Areas

  • Fracture fixation
  • Plates and screws
  • Intramedullary nails
  • Hip procedures
  • Knee procedures
  • Ankle / foot procedures
  • Upper-limb procedures

Spine Procedures

Spinal surgery requires intraoperative imaging for instrumentation placement and localisation across cervical, thoracic and lumbar regions.

Content under development

Topic Areas

  • Cervical
  • Thoracic
  • Lumbar
  • Instrumentation
  • Intraoperative localisation

Other Surgical Procedures

Image-guided surgical procedures extend beyond orthopaedics to include abdominal, urological, vascular and foreign-body localisation applications.

Content under development

Topic Areas

  • Abdominal
  • Urological
  • Vascular
  • Foreign-body localisation
  • Other established image-guided surgical procedures

Theatre Radiation Protection

Radiation protection in theatre requires awareness of scatter, staff positioning, distance, protective equipment and dose awareness for all theatre personnel.

Content under development

Topic Areas

  • Scatter
  • Staff positioning
  • Distance
  • Protective equipment
  • Dose awareness
  • Exposure optimisation

Fluoroscopy Fundamentals

Fluoroscopy provides real-time imaging for a range of diagnostic and interventional procedures. This module covers fluoroscopy equipment, image acquisition, pulsed fluoroscopy, magnification, fluoroscopy time and dose optimisation.

Content under development

Topic Areas

  • Fluoroscopy equipment
  • Flat-panel detector
  • Image acquisition
  • Pulsed fluoroscopy
  • Magnification
  • Fluoroscopy time
  • Dose optimisation

Upper Gastrointestinal Procedures

Upper GI fluoroscopy includes barium swallow, upper GI examination, oesophageal studies and small bowel follow-through.

Content under development

Topic Areas

  • Barium swallow
  • Upper GI examination
  • Oesophageal studies
  • Small bowel follow-through

Lower Gastrointestinal Procedures

Lower GI fluoroscopy covers barium enema examinations using single-contrast and double-contrast techniques, with attention to patient preparation and post-procedure considerations.

Content under development

Topic Areas

  • Barium enema
  • Single-contrast technique
  • Double-contrast technique
  • Patient preparation
  • Post-procedure considerations

Genitourinary Procedures

Genitourinary fluoroscopic procedures include IVU / IVP, cystography, MCU / VCUG, retrograde urethrogram and retrograde pyelography.

Content under development

Topic Areas

  • IVU / IVP
  • Cystography
  • MCU / VCUG
  • Retrograde urethrogram
  • Retrograde pyelography

Gynaecological Procedures

Gynaecological fluoroscopy includes hysterosalpingography for assessment of the uterine cavity and fallopian tubes.

Content under development

Topic Areas

  • Hysterosalpingography

Other Contrast Procedures

Additional fluoroscopic contrast procedures include sinogram, fistulogram, sialogram, arthrography, T-tube cholangiography and other established studies.

Content under development

Topic Areas

  • Sinogram
  • Fistulogram
  • Sialogram
  • Arthrography
  • T-tube cholangiography
  • Other established fluoroscopic procedures

Contrast & Patient Safety

Patient safety in fluoroscopy and contrast procedures includes preparation, contrast considerations, contraindications, adverse reactions, emergency preparedness and radiation protection. Where scope of practice differs internationally, the variation is identified rather than presenting one country's practice as universal.

Content under development

Topic Areas

  • Patient preparation
  • Contrast considerations
  • Contraindications / precautions
  • Adverse reactions
  • Emergency preparedness
  • Radiation protection

Principles of Paediatric Radiography

Paediatric radiography requires child-friendly communication, careful preparation, appropriate immobilisation and exposure optimisation to minimise repeat examinations. This module covers the core principles of imaging children.

Content under development

Topic Areas

  • Child-friendly communication
  • Preparation
  • Immobilisation
  • Positioning
  • Exposure optimisation
  • Minimising repeat examinations

Neonatal Radiography

Neonatal imaging in the NICU environment involves portable chest and abdomen imaging, assessment of lines and tubes, and imaging within incubators.

Content under development

Topic Areas

  • NICU environment
  • Portable chest
  • Abdomen
  • Lines and tubes
  • Incubator imaging

Paediatric Chest

Paediatric chest radiography covers standard and portable projections with attention to positioning and breathing considerations in children.

Content under development

Topic Areas

  • Chest projections
  • Portable imaging
  • Positioning
  • Breathing considerations

Paediatric Abdomen

Paediatric abdominal radiography includes supine, erect and decubitus projections for acute abdominal assessment in children.

Content under development

Topic Areas

  • Supine abdomen
  • Erect / decubitus where appropriate
  • Acute abdomen

Paediatric Musculoskeletal

Paediatric musculoskeletal radiography covers upper limb, lower limb, pelvis, spine and trauma imaging in children, with attention to growth plates and dose optimisation.

Content under development

Topic Areas

  • Upper limb
  • Lower limb
  • Pelvis
  • Spine
  • Trauma

Paediatric Skull & Facial Imaging

Paediatric skull and facial imaging requires careful attention to immobilisation, dose and the clinical appropriateness of each examination.

Content under development

Topic Areas

  • Skull
  • Facial bones
  • Other clinically appropriate examinations

Radiation Protection in Children

Children are more sensitive to radiation than adults, making justification and optimisation especially important. This module covers exposure selection, collimation and strategies to avoid repeat exposures in paediatric imaging.

Content under development

Topic Areas

  • Justification
  • Optimisation
  • Exposure selection
  • Collimation
  • Avoiding repeat exposures

Detailed content for each X-Ray topic is being developed and will be available soon. Every individual examination will follow a consistent 8-section format: Overview, Clinical Indications, Patient Preparation & Positioning, Radiographic Technique, Image Evaluation Criteria, Clinical Considerations & Modifications, Radiation Protection & Patient Safety, and Quick Reference.