Rad CS 2022
Rad CS 2022
Rad CS 2022
Radiography
The purpose of the exam is to assess the knowledge and cognitive skills underlying the intelligent
performance of the tasks typically required of the staff technologist at entry into the profession. The
tasks typically performed were determined by administering a comprehensive practice analysis
survey to a nationwide sample of radiographers.1 An advisory committee then determined the
knowledge and cognitive skills needed to perform the tasks on the task inventory and these are
organized into the content categories within this document. Every content category can be linked to
one or more tasks on the task inventory. The document is used to develop the examination. The
Task Inventory for Radiography may be found on the ARRT’s website (www.arrt.org).
The ARRT avoids content when there are multiple resources with conflicting perspectives.
Educational programs accredited by a mechanism acceptable to ARRT offer education and
experience beyond the minimum requirements specified in the content specifications and clinical
competency requirements documents.
This document is not intended to serve as a curriculum guide. Although ARRT programs for
certification and registration and educational programs may have related purposes, their functions
are clearly different. Educational programs are generally broader in scope and address the subject
matter that is included in these content specifications, but do not limit themselves to only this
content.
The table below presents the major content categories and subcategories covered on the
examination. The number of test questions in each category are listed in bold and the number of
test questions in each subcategory in parentheses. Specific topics within each category are
addressed in the content outline, which makes up the remaining pages of this document.
Content Category Number of Scored Questions2
Patient Care 33
Patient Interactions and Management (33)
Safety 50
Radiation Physics and Radiobiology3 (21)
Radiation Protection (29)
Image Production 51
Image Acquisition and Evaluation (26)
Equipment Operation and Quality Assurance (25)
Procedures 66
Head, Spine and Pelvis Procedures (18)
Thorax and Abdomen Procedures (20)
Extremity Procedures (28)
Total 200
1
A special debt of gratitude is due to the hundreds of professionals participating in this project as committee
members, survey respondents, and reviewers.
2
Each exam includes an additional 30 unscored (pilot) questions.
3
SI units are the primary (principle) units of radiation measurement used on the radiography examination.
1 COPYRIGHT© 2021 BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS® ALL RIGHTS RESERVED.
REPRODUCTION IN WHOLE OR PART IS NOT PERMITTED WITHOUT THE WRITTEN CONSENT OF THE ARRT.
RADIOGRAPHY ARRT BOARD APPROVED: JANUARY 2021
CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 2022
Patient Care
1. Patient Interactions and Management b. pre- and post-examination instructions
A. Ethical and Legal Aspects (e.g., preparation, diet, medications and
1. patients’ rights discharge instructions)
a. consent (*e.g., informed, oral, implied) c. respond to inquiries about other imaging
b. confidentiality (HIPAA) modalities (e.g., dose differences, types
c. American Hospital Association (AHA) of radiation, patient preps)
Patient Care Partnership (Patients’ Bill C. Ergonomics and Monitoring
of Rights) 1. body mechanics (e.g., balance, alignment,
1. privacy movement)
2. extent of care (e.g., DNR) a. patient transfer techniques
3. access to information b. safe patient handling devices (e.g.,
4. living will, health care proxy, transfer board, Hoyer lift, gait belt)
advanced directives 2. assisting patients with medical equipment
5. research participation a. infusion catheters and pumps
2. legal issues b. oxygen delivery systems
a. verification (e.g., patient identification, c. other (e.g., nasogastric tubes, urinary
compare order to clinical indication) catheters, tracheostomy tubes)
b. common terminology 3. patient monitoring and documentation
(e.g., battery, negligence, malpractice, a. vital signs
beneficence) b. physical signs and symptoms (e.g.,
c. legal doctrines (e.g., respondeat motor control, severity of injury)
superior, res ipsa loquitur) c. fall prevention
d. restraints versus positioning aids used to D. Medical Emergencies
eliminate motion artifact 1. non-contrast allergic reactions (e.g., latex)
e. manipulation of electronic data (e.g., 2. cardiac/respiratory arrest
exposure indicator, processing (e.g., CPR, AED)
algorithm, brightness and contrast, 3. physical injury or trauma
cropping or masking off anatomy) 4. other medical disorders
f. documentation (e.g., changes to order, (e.g., seizures, diabetic reactions)
medical event)
3. ARRT Standards of Ethics *The abbreviation “e.g.,” is used to indicate that examples are listed in
parentheses, but that it is not a complete list of all possibilities.
B. Interpersonal Communication
(Patient Care continues on the following page.)
1. modes of communication
a. verbal/written
b. nonverbal (e.g., eye contact, touching)
2. challenges in communication
a. interactions with others
1. language barriers
2. cultural and social factors
3. physical, sensory, or cognitive
impairments
4. age
5. emotional status, acceptance of
condition (e.g., stage of grief)
b. explanation of medical terms
c. strategies to improve understanding
3. patient education
a. explanation of current procedure (e.g.,
purpose, length of time, radiation dose)
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RADIOGRAPHY ARRT BOARD APPROVED: JANUARY 2021
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Safety
1. Radiation Physics and Radiobiology
A. Principles of Radiation Physics B. Biological Effects of Radiation
1. x-ray production 1. SI units of measurement (NCRP #160)
a. source of free electrons a. absorbed dose (Gy)
(e.g., thermionic emission) b. dose equivalent (Sv)
b. acceleration of electrons c. exposure (C/kg)
c. focusing of electrons d. effective dose (Sv)
d. deceleration of electrons e. air kerma (Gy)
2. target interactions 2. radiosensitivity
a. bremsstrahlung a. dose-response relationships
b. characteristic b. relative tissue radiosensitivities
3. x-ray beam (e.g., LET, RBE)
a. frequency and wavelength c. cell survival and recovery (LD50)
b. beam characteristics d. oxygen effect
1. quality 3. somatic effects
2. quantity a. cells
3. primary versus remnant (exit) b. tissue
c. inverse square law (e.g., eye, thyroid, breast, skin,
d. fundamental properties marrow, gonad)
(e.g., travel in straight lines, c. embryo and fetus
ionize matter) d. carcinogenesis
4. photon interactions with matter e. early versus late or acute versus
a. photoelectric chronic
b. Compton f. deterministic (tissue reactions)
c. coherent (classical) versus stochastic
d. attenuation by various tissues g. short-term versus long-term
1. thickness of body part exposure
2. type of tissue (atomic number) h. acute radiation syndromes
1. hemopoietic
2. gastrointestinal (GI)
3. central nervous system (CNS)
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RADIOGRAPHY ARRT BOARD APPROVED: JANUARY 2021
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Safety (continued)
2. Radiation Protection
A. Minimizing Patient Exposure B. Personnel Protection (ALARA)*
1. exposure factors 1. sources of radiation exposure
a. kVp a. primary x-ray beam
b. mAs b. secondary radiation
c. automatic exposure control (AEC) 1. scatter
2. beam restriction 2. leakage
a. purpose of primary beam restriction c. patient as source
b. types (e.g., collimators) 2. basic methods of protection
3. patient considerations a. time
a. positioning b. distance
b. communication c. shielding
c. pediatric 3. protective devices
d. morbid obesity a. types (e.g., aprons, barriers)
4. filtration b. attenuation properties
a. effect on skin and organ exposure c. minimum lead equivalent
b. effect on average beam energy (NCRP #102)
c. NCRP recommendations 4. special considerations
(NCRP #102, minimum filtration in a. mobile units
useful beam) b. fluoroscopy
5. radiographic dose documentation 1. protective drapes
6. image receptors 2. protective Bucky slot cover
7. grids 3. cumulative timer
8. fluoroscopy 4. remote-controlled fluoroscopy
a. pulsed c. guidelines for fluoroscopy and
b. exposure factors mobile units (NCRP #102, 21 CFR)
c. grids 1. fluoroscopy exposure rates
d. positioning (normal and high-level control)
e. fluoroscopy time 2. exposure switch guidelines
f. automatic brightness control (ABC) 5. radiation exposure and monitoring
or automatic exposure rate control a. dosimeters
(AERC) 1. types
g. receptor positioning 2. proper use
h. magnification mode b. NCRP recommendations for
i. air kerma display personnel monitoring (NCRP #116)
j. last image hold 1. occupational exposure
k. dose or time documentation 2. public exposure
l. minimum source-to-skin 3. embryo/fetus exposure
distance (21 CFR) 4. dose equivalent limits
9. dose area product (DAP) meter 5. evaluation and maintenance of
personnel dosimetry records
6. handling and disposal of radioactive
material
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RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021
CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022
Image Production
1. Image Acquisition and Evaluation
A. Factors Affecting Radiographic Quality
(X indicates topics covered on the examination.)
1. 2. 3.
Receptor Spatial Distortion
Exposure Resolution
a. mAs X
b. kVp X
c. OID X X
d. SID X X X
e. focal spot size X
f. grids* X
g. tube filtration X
h. beam restriction X
i. motion X
j. anode heel effect X
k. patient factors (size, pathology) X X X
l. angle (tube, part, or receptor) X X
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RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021
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RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021
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Procedures
This section addresses imaging procedures for the anatomic regions listed below. Questions will cover
the following topics:
1. Positioning (e.g., topographic landmarks, body positions, path of central ray, positioning aids,
respiration).
2. Anatomy (e.g., including physiology, basic pathology, related medical terminology).
3. Procedure adaptation (e.g., body habitus, body mass index, trauma, pathology, age, limited
mobility).
4. Evaluation of displayed anatomical structures (e.g., patient positioning, tube-part-image receptor
alignment).
The specific radiographic positions and projections within each anatomic region that may be covered on
the examination are listed in Attachment A. A guide to positioning terminology appears in Attachment B.
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RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021
CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022
Attachment A
Radiographic Positions and Projections
1. Head, Spine and Pelvis h. lateral flexion and 3. Sternum
A. Head extension a. lateral
1. Skull i. AP dens (Fuchs) b. RAO
a. AP axial (Towne) 2. Thoracic Spine 4. Soft Tissue Neck
b. lateral a. AP a. AP upper airway
c. PA axial (Caldwell) b. lateral, breathing b. lateral upper airway
d. PA c. lateral, expiration 5. Sternoclavicular joints
e. submentovertex (full basal) 3. Scoliosis Series a. PA
f. trauma cross-table a. AP or PA b. LAO and RAO
(horizontal beam) lateral b. lateral B. Abdomen and GI Studies
g. trauma AP axial (reverse 4. Lumbar Spine 1. Abdomen
Caldwell) a. AP a. AP supine
h. trauma AP b. PA b. AP upright
i. trauma AP axial (Towne) c. lateral c. lateral decubitus
2. Facial Bones d. L5-S1 lateral spot d. dorsal decubitus
a. lateral e. posterior oblique 2. Esophagus
b. parietoacanthial (Waters) f. anterior oblique a. RAO
c. PA axial (Caldwell) g. AP axial L5-S1 b. left lateral
d. modified parietoacanthial h. AP right and left bending c. AP
(modified Waters) i. lateral flexion and d. PA
3. Mandible extension e. LAO
a. axiolateral oblique 5. Sacrum and Coccyx 3. Swallowing Dysfunction Study
b. PA a. AP axial sacrum 4. Upper GI series*
c. AP axial (Towne) b. AP axial coccyx a. AP or PA scout
d. PA axial c. lateral sacrum and coccyx, b. RAO
e. PA (modified Waters) combined c. PA
f. submentovertex (full basal) d. lateral sacrum or coccyx, d. right lateral
4. Temporomandibular Joints separate e. LPO
a. axiolateral oblique 6. Myelography f. AP
(modified Law) 7. Sacroiliac Joints 5. Small Bowel Series
b. axiolateral (modified a. AP axial a. PA scout
Schuller) b. posterior oblique b. PA (follow through)
c. AP axial (modified Towne) c. anterior oblique c. ileocecal spots
5. Nasal Bones 8. Pelvis and Hip 6. Contrast Enema*
a. parietoacanthial (Waters) a. AP hip only a. left lateral rectum
b. lateral b. cross-table (horizontal b. left lateral decubitus
c. PA axial (Caldwell) beam) lateral hip c. right lateral decubitus
6. Orbits c. unilateral frog-leg, non- d. LPO and RPO
a. parietoacanthial (Waters) trauma e. PA
b. lateral d. axiolateral inferosuperior, f. RAO and LAO
c. PA axial (Caldwell) trauma (Clements- g. AP axial (sigmoid)
d. modified parietoacanthial Nakayama) h. PA axial (sigmoid)
(modified Waters) e. AP pelvis i. PA or AP post-evacuation
7. Paranasal Sinuses f. AP pelvis, bilateral frog-leg 7. Surgical Cholangiography
a. lateral, horizontal beam g. AP pelvis, axial anterior 8. ERCP
b. PA axial (Caldwell), pelvic bones (inlet, outlet)
horizontal beam h. posterior oblique pelvis, *single or double contrast
c. parietoacanthial (Waters), acetabulum (Judet)
horizontal beam 2. Thorax and Abdomen
d. submentovertex (full A. Thorax
basal), horizontal beam 1. Chest
B. Spine and Pelvis a. PA or AP upright
1. Cervical Spine b. lateral upright
a. AP axial c. AP lordotic
b. AP open mouth d. AP supine
c. lateral e. lateral decubitus
d. cross-table (horizontal 2. Ribs
beam) lateral a. AP and PA, above and
e. PA axial obliques below diaphragm
f. AP axial obliques b. anterior and posterior
g. lateral swimmers obliques
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RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021
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Attachment B
Standard Terminology
for Positioning and Projection
Radiographic View: Describes the body part as seen by the image receptor. Restricted to the
discussion of a radiograph or image.
Radiographic Position: Refers to a specific body position, such as supine, prone, recumbent, erect or
Trendelenburg. Restricted to the discussion of the patient’s physical position.
Radiographic Projection: Restricted to the discussion of the path of the central ray.
POSITIONING TERMINOLOGY
A. Lying Down
1. supine − lying on the back
2. prone − lying face downward
3. decubitus − lying down with a horizontal x-ray beam
4. recumbent − lying down in any position
B. Erect or Upright
1. anterior position − facing the image receptor
2. posterior position − facing the radiographic tube
C. Either Upright or Recumbent
1. oblique torso positions
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