Procedures (72 scored questions)

ARRT-R · 108 questions

A 24-year-old outpatient presents for a lateral elbow after a fall, immobilized at 90 degrees flexion. The image shows the joint space, radial head free of coronoid overlap, but humeral epicondyles are not superimposed and the capitulum appears elongated. Central ray was angled slightly. Which evaluation confirms positioning accuracy and tube-part-receptor alignment for the lateral elbow?
An adult with obstructive jaundice and suspected common bile duct stones is scheduled in a GI suite where a duodenoscope is advanced to the ampulla and contrast is injected under fluoroscopy to opacify the biliary and pancreatic ducts for diagnosis and stone removal. Which fluoroscopic biliary procedure uses endoscopic cannulation to visualize the ducts?
An 18-year-old soccer player has a suspected eversion injury in the ED with swelling but no fracture on AP and lateral ankle views. The physician orders a mortise view to assess the tibiotalar joint space and needs it open and symmetric. Which positioning maneuver best produces the mortise projection for tibiotalar assessment?
A 45-year-old adult in the emergency department is ordered an upright PA chest for dyspnea. She stands facing the receptor with weight evenly distributed, chin extended, mid-sagittal plane perpendicular to the receptor and midcoronal plane parallel to it, with the central ray horizontal. Which positioning statement correctly describes topographic plane alignment and central ray path for this PA chest?
A 14-year-old gymnast has uneven shoulders and a rib hump on forward bend, suggesting idiopathic scoliosis. She can stand erect without support, has no trauma, and the orthopedist needs full-spine curvature measurement with minimal breast dose. Which scoliosis projection protocol best demonstrates curvature while minimizing dose?
A 28-year-old warehouse worker fell onto the left side and has focal tenderness over the left lateral 9th-10th ribs. The patient can stand upright but cannot raise the left arm overhead due to pain. The physician suspects a lower axillary rib injury without pneumothorax. Which rib projection protocol best demonstrates the suspected lower rib injury?
A frail 84-year-old woman arrives by wheelchair after a fall with severe right hip pain, marked kyphosis, and inability to straighten her legs or transfer to the table. The order is AP pelvis and trauma lateral hip, and she cannot tolerate log-rolling. Which adaptation correctly modifies positioning for habitus, trauma, and limited mobility?
A critical-care nurse places an enteric feeding tube at bedside and requests radiographic confirmation before feeding, while an interventional team uses mobile fluoroscopy to advance a PICC toward the superior vena cava in another room. Both need imaging guidance. Which radiographic criterion confirms correct placement for enteric tube feeding versus PICC tip position?
A 19-year-old inpatient comes to radiology for erect PA and lateral chest to evaluate a possible small pneumothorax. She slouches, lifts her shoulders, and takes shallow breaths at varying depths. A radiolucent sponge and coaching time are available. Which respiration instruction and positioning aid use best demonstrates full lung expansion for this chest study?
A 78-year-old inpatient fell from bed onto the hip, has pelvic pain and shortening, is hemodynamically stable, can tolerate brief positioning, and the physician suspects pelvic ring disruption needing superior and inferior displacement detail. Which pelvis projection combination best demonstrates pelvic ring integrity and displacement?
A 22-year-old clinic patient with anterior knee pain needs a Merchant view to evaluate the patellofemoral joint after standard AP and lateral knee images. The room has a Merchant board, the patient is mobile, and the surgeon wants both patellae with joint spaces open. Which positioning setup best demonstrates the patellofemoral joint using the Merchant method?
A toddler arrives drooling with suspected button-battery ingestion and a school-age child presents with sudden choking and inspiratory stridor after inhaling a peanut. Both need airway and ingested foreign body assessment without delay. Which soft tissue neck and foreign body imaging approach should the technologist use for airway versus ingestion?
A 7-year-old referred by pediatrics for short stature arrives with a guardian asking about growth-plate imaging, and the order reads bone age study with no trauma history. The department protocol requires minimal dose and a standard reference for maturity. Which protocol best evaluates skeletal maturity for the bone age study?
An adult with severe abdominal pain and suspected free air cannot stand for long, vomits when flat for an acute abdomen series, and needs demonstration of air-fluid levels. The technologist must choose positions that balance safety and diagnostic needs. Which abdomen position combination should the technologist perform for supine, upright and decubitus needs?
A 45-year-old outpatient stands for a routine PA chest for clearance, chin elevated, shoulders rotated forward, and chest against the upright receptor. The exposure is made at full inspiration with the central ray horizontal to mid-chest. The image shows 10 posterior ribs above the diaphragm with clavicular heads equidistant from the spine. Which image finding confirms accurate positioning and tube-part-receptor alignment for this PA chest?
A 50-year-old inpatient is scheduled for fluoroscopic lumbar myelography for leg weakness, with consent signed and labs showing normal coagulation. The radiologist plans prone oblique positioning, contrast injection via lumbar puncture, then Trendelenburg tilting and CT follow-up. The nurse asks what assistance and monitoring you will provide. Which peri-procedural support plan best reflects myelography, lumbar puncture, and epidural injection principles?
A 19-year-old college athlete presents to urgent care after a elbow to the face, with periorbital swelling, double vision on upward gaze, and suspected orbital floor fracture. The provider requests facial bones without CT initially. The patient can sit upright and extend the neck. Which projection and positioning best demonstrates the orbits and sinuses for this suspected blowout injury?
A 28-year-old carpenter presents with snuffbox tenderness after a fall on an outstretched hand, and the physician suspects a scaphoid fracture that was occult on standard wrist views. The hand is ulnarly deviated to isolate the bone. Which specialized wrist projection best elongates the scaphoid to demonstrate a nondisplaced fracture?
A 74-year-old inpatient after a left-brain stroke coughs when drinking thin liquids and pockets food in the cheeks. The patient is alert, can sit upright in a chair, and has no bowel obstruction signs. Speech therapy and radiology plan a fluoroscopic aspiration assessment with varied food textures. Which fluoroscopic swallowing protocol best evaluates the aspiration risk?
A 52-year-old warehouse worker has chronic neck stiffness with radiating arm tingling, cleared for movement, and needs evaluation of intervertebral foramina and alignment. The surgeon requests cervical obliques plus flexion and extension views. The patient is mobile but anxious about bending. Which projection set best demonstrates cervical foramina and stability for this degenerative case?
A thin older adult with pleuritic pain needs upper rib detail above the diaphragm. She is upright, mildly kyphotic, breathes shallowly, and drifts without support. The order specifies no rotation with best cortical detail. Which respiration and aid combination correctly demonstrates the upper ribs with optimal positioning?
A 55-year-old with chronic shoulder pain and limited abduction needs evaluation of the glenohumeral joint space without rib overlap, and the physician also wants to assess anterior dislocation with humeral head position relative to the glenoid. Which shoulder projections best demonstrate the joint space and then confirm humeral head alignment?
A 45-year-old outpatient is scheduled for fluoroscopic shoulder arthrography with iodinated contrast to evaluate a suspected labral tear, with no reported allergies and normal labs. The radiologist will perform sterile joint injection and needs radiographer support. Which support step best promotes safe joint injection for contrast arthrography?
An outpatient adult needs a retrograde cystogram after pelvic trauma to check for bladder rupture, and the urologist has placed a Foley catheter with balloon inflated. The radiologist requests AP and bilateral oblique images with contrast instilled by gravity drip to a specified volume. Which imaging control best confirms bladder integrity during cystography?
A 74-year-old inpatient has acute left lower quadrant pain, fever, and CT concern for diverticular microperforation with contained leak. The surgeon requests a fluoroscopic enema to assess for free communication, and gastroenterology plans ERCP next week for choledocholithiasis. The patient is afebrile enough for a cautious study with surgical backup. Which enema contrast strategy best evaluates suspected perforation while preserving ERCP planning?
An urgent-care adult with facial trauma after a fall has suspected orbital floor and maxillary sinus fluid levels, is upright and cooperative, and can extend the neck without C-spine precautions. The physician wants air-fluid levels and facial bones without CT. Which paranasal sinus projection best demonstrates air-fluid levels in the maxillary sinuses while showing facial bones?
A warehouse worker fell from a ladder onto the heels, with severe right heel pain and swelling, plus forefoot pain on the same side. The orders request right calcaneus and foot views, but the patient cannot bear weight and cannot dorsiflex well. Which projection set correctly evaluates calcaneal articulation and forefoot alignment under non-weight-bearing limits?
A 28-year-old emergency patient fell onto the left chest, has point tenderness over ribs 7-9 in the midaxillary line, takes shallow breaths, and needs rib detail without repeating chest work already done. The physician wants the site of injury demonstrated with minimal superimposition. Which projection strategy best demonstrates left axillary rib injury?
An adolescent with suspected idiopathic scoliosis arrives with a back brace, a pediatrician order for erect PA and lateral full-spine views, and no history of trauma. The supervisor stresses gonadal shielding, breathing technique, and inclusion from C7 to sacrum without rotation. Which scoliosis series approach best meets positioning and shielding requirements?
A 34-year-old emergency patient needs a supine AP abdomen to include pubic symphysis, kidneys, and lateral soft tissues, with correct mid-sagittal plane alignment and no rotation for obstruction workup. Which topographic landmark and central ray path should the radiographer use to include the required anatomy?
A 78-year-old kyphotic patient with a suspected left hip fracture arrives on a stretcher, cannot stand or abduct the painful leg, has severe osteoporosis, and needs AP pelvis plus lateral hip views without worsening injury. Which trauma-adapted positioning modification should the radiographer apply to obtain diagnostic views safely?
A 38-year-old with chronic neck stiffness and arm tingling needs routine cervical spine views plus motion assessment, with no trauma and full cooperation. The order asks for disc mobility without MRI. Which cervical spine projection set best evaluates alignment, foramina, and flexion-extension motion?
An ED patient with a fall has a painful right hip, cannot abduct the leg, and needs acetabular assessment without further rotation. The physician orders AP pelvis, unilateral frog-leg, and acetabular views. Which projection set correctly applies Judet and inlet-outlet concepts while respecting the mobility limit?
A 68-year-old dysphagic stroke patient on a medical floor needs enteral feeding after an indwelling small-bore feeding tube was advanced at bedside. Aspiration pH is equivocal, and the physician orders a portable abdomen to confirm placement before feeding. The nurse asks if feeding can start. Which radiographic verification best confirms safe enteric placement before feeding?
A 4-year-old outpatient drools and refuses to swallow after reportedly swallowing a coin, is breathing comfortably, can sit upright, and the physician needs to locate a radiopaque esophageal foreign body and exclude airway involvement. Which soft-tissue neck and thorax protocol best localizes the ingested foreign body?
A 54-year-old emergency patient has acute abdominal pain with suspected free intraperitoneal air, can sit upright briefly but cannot stand, and has no trauma. The surgeon needs to see both free air and air-fluid levels with the least discomfort. Which abdomen series best demonstrates free air and levels in this patient?
A teen athlete with recurrent patellar dislocation needs a Merchant view, plus evaluation of the intercondylar notch after a twisting knee injury, while an elderly patient needs a distal femur fracture series. Which positioning and beam-angle combination best demonstrates the patellofemoral joint, intercondylar fossa, and distal femur?
A 48-year-old outpatient arrives for fluoroscopic lumbar myelography for stenosis, reports shellfish allergy and takes apixaban, with orders for prone oblique spot images and post-procedure CT. Consent, labs, and allergy review are pending. Which pre-procedure and positioning coordination best supports safe myelography?
A pediatric endocrinology clinic refers a 9-year-old with short stature for bone age, and orthopedics adds bilateral femorotibial length measurement for suspected leg-length difference. The child is anxious and parents ask about radiation and positioning. Which protocol correctly acquires bone age and long bone measurement images with calibration and minimal repeats?
A 25-year-old athlete has a mediolateral left knee projection for ligament injury, the image shows the femoral condyles, patella, and joint space, but rotation and tube-part-receptor alignment are uncertain. Which image evaluation criterion confirms accurate positioning with proper alignment for this mediolateral knee?
A 16-year-old with suspected adolescent idiopathic scoliosis needs an initial standing curvature assessment, and her 68-year-old grandmother needs sacroiliac joint pain evaluation after a fall without fracture on lumbar views. Which projection pairing best demonstrates spinal curvature and SI joint anatomy for these two patients?
A 34-year-old warehouse worker fell on an outstretched hand, now with ulnar-sided wrist pain when gripping a hammer and thumb pain at the thenar area. The physician suspects a hook of hamate fracture and a thumb sesamoid injury and requests dedicated wrist and thumb views beyond routine PA and lateral. Which supplementary projection pair best demonstrates those suspected injuries?
A 28-year-old warehouse worker fell onto the shoulder during a morning shift and has point tenderness over the acromioclavicular region without deformity suggesting dislocation. The patient can stand upright and lift light weights symmetrically, and the physician suspects a low-grade separation. Which AC joint projection protocol best demonstrates joint separation in this patient?
A 62-year-old outpatient with progressive dysphagia is scheduled for an esophagram to evaluate a mid-esophageal lesion. The radiologist wants live swallowing dynamics plus distended mucosal detail, with no gastric or small-bowel follow-through. Which contrast administration sequence should the radiographer prepare for this esophagram swallowing study?
A 34-year-old construction worker arrives in the ED after a fall with severe left groin pain and suspected femoral neck fracture. The patient remains supine, cannot abduct or internally rotate the injured leg, and tolerates only stretcher transfer. The unaffected leg is elevated out of the beam path while the injured leg stays extended in neutral. Which hip projection best visualizes the femoral neck without moving the injured leg for this trauma presentation?
An adult outpatient arrives for voiding cystourethrography after recurrent UTIs. Contrast fills the bladder via catheter, and the radiologist asks for voiding images of the urethra in progress. The table is fluoroscopic with spot imaging capability. Which imaging action best completes the cystourethrography evaluation of the urethra?
An adult outpatient for PA chest has shallow breathing from rib pain, needs full inspiration with no motion, and the department uses a standing chest unit with a step stool nearby. Which respiration instruction with a positioning aid best achieves full lung expansion and stability for the PA chest?
An adult outpatient arrives in fluoroscopy for a right shoulder arthrogram for suspected labral tear, with consent signed, allergies reviewed, and a sterile arthrography tray prepared. The radiologist will perform the joint injection and possible aspiration under fluoroscopic guidance with your assistance. Which sterile assisting step best supports safe joint injection and aspiration?
A 34-year-old outpatient is referred for evaluation of left optic canal narrowing to rule out stenosis. She can lie prone comfortably, can extend her neck, and has no acute facial trauma or precautions. The order requests a nontrauma orbit series emphasizing the optic foramen without superimposition of the opposite orbit. Which orbit projection should the technologist perform to best demonstrate the optic foramen?
A radiologist asks the technologist to assist with a fluoroscopic lumbar myelogram on an adult with chronic low back pain and prior spinal fusion, requiring prone positioning, sterile lumbar puncture, and intrathecal contrast injection with table tilting. Which technologist assisting role best supports safe myelography and lumbar puncture protocol for this spine case?
A high-school soccer player with a suspected lateral malleolar fracture needs an ankle series in a small ED room with a wall Bucky. The physician wants the tibiofibular joint open without overlap to assess stability. Which ankle positioning action best demonstrates the mortise joint space on this injured athlete?
A 58-year-old inpatient with incomplete colonoscopy due to tortuosity is ordered for a fluoroscopic contrast enema to evaluate the sigmoid colon for stricture, with no biliary symptoms or recent surgery. The radiologist wants mucosal relief with safe pressure control. Which enema setup should the radiographer prepare for this single-contrast evaluation?
An ED trauma patient with mid-back pain after a fall needs a supine AP thoracic spine without moving the patient. The technologist must include all twelve thoracic vertebrae using surface landmarks, a true coronal alignment reference and a perpendicular beam. Which landmark, plane and central ray combination correctly includes the thoracic spine for this AP projection?
A 64-year-old patient arrives in the ED after a steering-wheel impact with midline sternal tenderness and dyspnea. She can stand briefly but cannot lie prone because of pain. The physician orders a sternum series to evaluate for fracture. Which projection selection best visualizes the sternum while respecting this positioning limit?
A toddler arrives at urgent care with stridor after suspected peanut aspiration. The radiologist requests inspiratory and expiratory chest films and a soft-tissue neck series. The child is crying and moving. Which imaging strategy best evaluates airway foreign body and soft-tissue neck?
An older adult with a painful hip fracture, large body habitus, and limited mobility arrives by stretcher and cannot stand, rotate, or tolerate prolonged positioning for a trauma pelvis and lateral hip. Vital signs are stable but movement causes severe pain and the team needs diagnostic images quickly. Which procedural adaptation best addresses habitus, trauma, pathology, age, and limited mobility?
A 54-year-old oncology patient in interventional radiology needs C-arm verification of a right basilic PICC tip at the cavoatrial junction, with no enteric tube in place and stable vitals. The physician asks the radiographer to provide pulsed imaging while advancing the catheter. Which C-arm imaging collaboration should the radiographer provide for this PICC line placement?
A school-age child with recurrent urinary infections is scheduled for voiding cystourethrography after a scout image, requiring bladder catheterization, iodinated contrast filling, and voiding views under fluoroscopy. Which cystourethrography protocol element best demonstrates bladder and urethral anatomy while maintaining sterile technique for this pediatric case?
A 35-year-old with neck pain after whiplash needs routine cervical views plus open neural foramina, with no fracture on lateral and full head rotation possible. Which oblique cervical positioning best opens the lower neural foramina perpendicular to the image receptor?
A 19-year-old volleyball player has bilateral anterior knee pain and crepitus when climbing stairs, without trauma, effusion, or suspected fracture. The orthopedist suspects patellofemoral tracking disorder and wants both patellae compared for subluxation with the knees flexed and the beam tangent to the joint. Which tangential patella method best meets the bilateral comparison need?
An adult ED patient has severe abdominal pain with suspected free intraperitoneal air. The patient cannot stand but can lie on the side with hips flexed. The surgeon needs air under the diaphragm or over the liver. Which abdomen positioning best demonstrates pneumoperitoneum when upright is impossible?
A portable AP knee image shows the joint space closed, the patella displaced laterally, and one femoral condyle more distal than the other, with elongated tibial detail and increased density on one side. The technologist must decide if the error reflects positioning or tube-part-receptor alignment before repeating. Which evaluation of positioning accuracy and alignment best explains the image?
A pediatric endocrinologist orders skeletal maturity assessment for a 5-year-old with early breast development and rapid height gain, and the clinic has no prior bone age images. The child is cooperative, the left hand is uninjured, and the parents ask why only a small body part is imaged. Which examination correctly completes bone age assessment in this patient?
A 24-year-old rock climber with ulnar-sided wrist pain after a fall needs evaluation for suspected scapholunate injury and hook of hamate fracture, with moderate swelling but no deformity. The physician orders PA, oblique, lateral and scaphoid views plus ulnar deviation. Which projection set should the radiographer perform for this wrist assessment?
A 14-year-old is referred for suspected idiopathic scoliosis with a visible thoracic rib hump and no prior spinal hardware. She can stand erect without support and the physician requests standing frontal and lateral views of the entire spine to measure curvature. Which scoliosis series protocol should the technologist use to assess curvature while limiting anterior breast dose?
An adult presents to urgent care after a direct blow to the anterior chest with focal sternal tenderness and stable vitals, and the physician suspects a sternal fracture without rib displacement. The technologist must select sternal views that avoid overlapping the thoracic spine. Which sternal projection set and breathing technique best profiles the sternum for this anterior trauma case?
An outpatient with chronic shoulder pain is scheduled for fluoroscopic shoulder arthrography with joint injection of iodinated contrast followed by aspiration if fluid is encountered. The radiologist asks the radiographer to set up and assist using sterile technique and time-out. Which assistance approach best supports safe arthrographic joint injection and aspiration?
A 55-year-old emergency patient after a low-speed motorcycle crash has lateral pelvic pain and suspected pelvic ring disruption. She is hemodynamically stable, can remain supine, and tolerates small tube angles but cannot roll into oblique positions. Which pelvic projection should the technologist add to the AP pelvis to best evaluate superior-inferior displacement of the ring?
A 62-year-old inpatient after a fall has left lower lateral rib pain below the diaphragm, can sit upright on a stretcher with back support but breathes shallowly, and cannot lift the arm overhead without pain. Which respiration phase and positioning-aid setup best visualizes below-diaphragm ribs while limiting motion and discomfort?
An emergency physician orders an esophagram for an older adult with severe chest pain after vomiting, suspected esophageal perforation, and no known iodine allergy, and the fluoroscopy team must choose contrast safely. Which contrast protocol should the radiographer prepare for the esophagram to evaluate suspected perforation?
A 28-year-old emergency patient with a painful shoulder after a fall can stand but cannot abduct the arm, and the physician needs a true glenohumeral joint space to check for anterior dislocation. The clavicle and scapular body overlap the joint on the routine AP. Which shoulder projection best demonstrates the glenohumeral joint space for this patient?
A 4-year-old with sudden drooling, stridor, and a suspected swallowed coin arrives after hours, is stable for radiography, and the physician requests neck and chest localization before endoscopy. Which soft tissue neck and foreign body protocol best demonstrates an ingested versus aspirated object?
A 45-year-old outpatient is scheduled for lumbar myelography for suspected spinal stenosis, the radiologist will perform a fluoroscopically guided lumbar puncture with iodinated contrast, and the radiographer is assigned to set up, assist sterilely, and monitor the patient in a small fluoroscopy suite. The consent and labs are verified and emergency equipment is present. Which radiographer assistance sequence should be used to support safe myelography and lumbar puncture technique?
A 52-year-old with severe abdominal pain and suspected bowel obstruction can stand briefly but cannot lie prone, has no trauma, and the surgeon needs both intraluminal gas patterns and possible free air. Which abdomen positioning combination best answers both requirements?
A surgeon requests imaging for a middle-aged patient on postoperative day two after cholecystectomy with a T-tube in place, normal vitals, and concern for a retained common bile duct stone. Which imaging approach should the radiographer prepare to evaluate the biliary ducts through the surgical drain?
A 45-year-old emergency patient needs an AP supine abdomen projection to evaluate bowel obstruction. The radiographer must use topographic landmarks and body planes to center and direct the central ray. Which landmark, plane, and central ray combination best produces the required anatomy?
A 19-year-old soccer player with a twisting ankle injury has swelling but can bear weight briefly, and the physician wants the tibiofibular mortise opened to rule out a fracture. Routine AP and lateral views show overlapping joint spaces. Which ankle projection positioning best opens the mortise joint for evaluation?
A trauma clinic receives an ambulatory adult with a suspected depressed left zygomatic arch after a sports collision and also needs routine sinus screening for chronic congestion. The physician wants the arch profiled without overlap and sinuses shown air-filled in one erect view. Which projection pairing best demonstrates the zygomatic arch and paranasal sinuses?
A 78-year-old patient with a suspected hip fracture arrives on a stretcher, in severe pain with limited mobility, a short stature and barrel chest, plus chronic lung disease. Moving the leg is contraindicated until cleared. Which procedural adaptation best obtains diagnostic hip images while respecting habitus, trauma, pathology and age?
A 34-year-old patient with recurrent urinary tract infections is scheduled for fluoroscopic voiding cystourethrography in the late morning, has no known contrast allergy, has emptied the bladder on arrival, and the urologist requests evaluation of the bladder and urethra during filling and voiding. Which contrast administration principle should the radiographer prepare to support for this cystography-based examination?
A 68-year-old with progressive dysphagia and weight loss is scheduled for morning esophagram and possible upper GI, has diabetes with morning insulin, and the radiologist wants motility and mucosal detail without aspiration. Which esophagram and upper GI preparation and contrast approach best meets safety and diagnostic needs?
An interventional team uses C-arm fluoroscopy to place a peripherally inserted central catheter in a cachectic adult with difficult arm veins, sterile field ready, and tip position must be confirmed. Which fluoroscopic endpoint should the radiographer recognize to confirm correct PICC placement?
A spine clinic sees a middle-aged driver with chronic neck stiffness needing instability assessment and a warehouse worker with oblique low-back pain radiating down one leg. The orders request motion evaluation of C-spine ligaments and posterior element detail of L-spine. Which projection combination best evaluates cervical instability and lumbar posterior elements?
A 24-year-old volleyball player with anterior knee pain and suspected patellar maltracking needs the patellofemoral joint space shown without superimposition. The patient can flex both knees over the table edge while seated. Which patella projection method best demonstrates the patellofemoral articulation for this patient?
A young adult arrives with snuffbox tenderness after a fall on an outstretched hand, swelling is mild, and the physician suspects a nondisplaced scaphoid fracture needing subtle fracture detail. Which wrist projection should the radiographer include to best demonstrate the scaphoid without overlap?
An emergency department adult presents with severe abdominal distension and suspected sigmoid volvulus with possible perforation. The surgeon requests a contrast enema under fluoroscopy, emphasizes low pressure, and remains available for complications. Which contrast enema protocol best addresses suspected perforation with surgical risk?
A 17-year-old with known scoliosis arrives for an erect series and also reports tailbone pain after a fall. The order includes PA erect spine to include C7 to sacrum plus dedicated sacrum and coccyx views. Which dedicated sacrum positioning best demonstrates the sacrum without coccyx overlap?
Overnight portable AP chest on an intubated adult in ICU shows the medial clavicle ends asymmetric to the spine, the right lung apex clipped, and the scapulae overlapping the lateral lungs with the central ray angled low. Which positioning accuracy and tube-part-receptor alignment error does the image demonstrate?
A 6-year-old child is referred from pediatric endocrinology for short stature with an early growth spurt and no history of hand trauma. The order requests bone age assessment using minimal exposure and a standardized comparison method unaffected by dominant-hand use. Which projection and comparison standard should the radiographer use for bone age assessment?
An adult with a direct blow to the anterior chest has focal sternal pain without dyspnea. The physician needs a sternal fracture check without spinal overlap, and the patient can lie semi-prone. Which sternal projection should the technologist select to best display the sternum clear of the spine?
A 58-year-old outpatient with chronic right knee pain is scheduled for fluoroscopic contrast knee arthrography, can lie supine with the knee supported, reports no contrast allergy, and the radiologist needs sterile joint access with confirmed intra-articular placement before injection. Which arthrography workflow best ensures safe sterile access and placement?
A 68-year-old after a fall has left hip pain and cannot abduct the leg, with concern for femoral neck fracture and possible posterior dislocation. The surgeon needs a lateral hip view without moving the injured femur. Which pelvis and hip projection best demonstrates the lateral hip under this constraint?
A 9-year-old with a suspected elbow effusion after a playground fall is anxious, in pain, and unable to remain still, and the order requests upper-limb views that require precise positioning without motion. The parent can assist, the child can follow short breathing cues, and sandbags, tape, and sponges are available. Which respiration and positioning-aid strategy best produces diagnostic images in this child?
A preschool child arrives with sudden choking, wheezing, and suspected peanut aspiration, now stable and cooperative. The physician wants to detect air trapping from a radiolucent airway foreign body. Which soft tissue and chest approach should the technologist select to evaluate movable airway obstruction?
An intensive care patient needs bedside verification of a newly placed nasogastric tube for medication delivery, and a separate oncology patient needs PICC tip confirmation under C-arm fluoroscopy. The team requests low-dose real-time guidance. Which line placement imaging role best ensures safe PICC and enteric tube positioning?
In the emergency department a 32-year-old fall patient holds the arm adducted in pain, the routine AP shows overlap of the humeral head and glenoid, and the physician needs humeral head position without abducting the injured shoulder to rule out anterior dislocation. Which shoulder projection should the radiographer obtain next to show glenohumeral relationship in this trauma setting?
An adult is ordered an AP lumbar spine with the technologist palpating the iliac crests supine, aligning the midsagittal plane perpendicular to the table, and centering the cassette to include T12 to sacrum. The requisition emphasizes topographic accuracy and orthogonal planes. Which central ray path should the technologist use to satisfy positioning principles for planes and landmarks?
A 19-year-old collegiate wrestler reports jaw clicking and limited opening after years of strain, and the physician suspects temporomandibular joint dysfunction without acute fracture. The patient can open and close the mouth on command and can tolerate upright positioning with the head carefully aligned. Which TMJ projection strategy best demonstrates joint function in this patient?
A teenage athlete with a suspected scaphoid fracture and ulnar-sided wrist pain after a fall needs initial and specialized views without excessive rotation. The physician requests minimal displacement stress. Which wrist imaging combination best demonstrates scaphoid and ulnar-sided anatomy while limiting motion?
An emergency adult with severe abdominal pain cannot stand, and the surgeon needs to know if free intraperitoneal air is present before calling the operating room. Supine images show no clear extraluminal gas. Which abdominal position should the technologist use next to best demonstrate pneumoperitoneum without an upright view?
In a sports clinic a 19-year-old soccer player has lateral ankle pain after inversion, the AP and lateral are normal, and the physician suspects syndesmotic widening that requires symmetric joint spaces on a true mortise view for comparison. Which positioning action should the radiographer take to obtain an optimal ankle mortise projection?
A 46-year-old with leg weakness is scheduled for fluoroscopy-guided lumbar myelography with iodinated contrast, needing consent, time-out and sterile needle placement in the subarachnoid space. Which technologist assistance best supports safe myelography and lumbar puncture performance?
A hypersthenic adult with a wide transverse abdomen and limited ability to hold a deep breath arrives for a supine KUB to check a ureteral stent, with a standard 35x43-cm detector available. The patient is comfortable supine but anatomy exceeds one field. Which adaptation should the technologist choose for body habitus and limited mobility during this KUB?
An adult with a painful shoulder after a fall cannot abduct the arm, and the physician suspects anterior dislocation with a Hill-Sachs defect. The technologist must choose views that avoid further injury. Which shoulder imaging combination best evaluates dislocation and humeral head defects without abduction?
A 38-year-old warehouse worker with chronic neck stiffness and prior whiplash needs assessment of atlantoaxial stability and neural foramina, able to flex and extend slowly without numbness. Which cervical spine projection series including flexion, extension, and obliques best answers the clinical question?
A middle-aged adult with chronic heartburn and suspected small hiatal hernia is scheduled for fluoroscopic barium evaluation, able to tolerate Trendelenburg and multiple positions. Which contrast examination and maneuver should the technologist prepare to best demonstrate reflux and sliding hernia?
A 5-year-old with recurrent urinary infections is scheduled for voiding cystourethrography to assess reflux, needing bladder filling through a catheter, fluoroscopic imaging and voiding views. Which cystography technique best demonstrates vesicoureteral reflux and urethral anatomy?
A 28-year-old motorcyclist arrives on a backboard with a swollen deformed mid-leg after a low-speed crash. The knee and ankle move minimally, distal pulses are intact, and the ED suspects a spiral tibial shaft fracture. The patient cannot stand or rotate the leg freely. Which tibia-fibula projection series should the technologist perform to include both adjacent joints for fracture assessment?