ARRT Radiography Content PDF

EXAMINATION CONTENT SPECIFICATIONS ARRT BOARD APPROVED: JANUARY 2021 IMPLEMENTATION DATE: JANUARY 1, 2022 Radiography The purpose of the exam is to assess the knowledge and cognit...

EXAMINATION CONTENT SPECIFICATIONS ARRT BOARD APPROVED: JANUARY 2021 IMPLEMENTATION DATE: JANUARY 1, 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) 2  RADIOGRAPHY ARRT BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 2022 Patient Care (continued) E. Infection Control G. Pharmacology 1. chain of infection (cycle of infection) 1. patient history a. pathogen a. medication reconciliation b. reservoir (current medications) c. portal of exit b. premedications d. mode of transmission c. contraindications 1. direct d. scheduling and sequencing a. droplet examinations b. direct contact 2. administration 2. indirect a. routes (e.g., IV, oral) a. airborne b. supplies (e.g., enema kits, needles) b. vehicle borne (fomite) c. procedural technique (e.g., c. vector borne (mechanical or venipuncture) biological) d. contrast media dose calculation e. portal of entry 3. contrast media types and properties f. susceptible host (e.g., iodinated, water soluble, barium, 2. asepsis ionic versus non-ionic) a. equipment disinfection 4. appropriateness of contrast media b. equipment sterilization to examination c. medical aseptic technique a. patient condition d. sterile technique (e.g., perforated bowel) 3. CDC Standard Precautions b. patient age and weight a. hand hygiene c. laboratory values b. use of personal protective (e.g., BUN, creatinine, eGFR) equipment (e.g., gloves, 5. complications/reactions gowns, masks) a. local effects c. safe handling of contaminated (e.g., extravasation/infiltration, equipment/surfaces phlebitis) d. disposal of contaminated materials b. systemic effects 1. linens 1. mild 2. needles 2. moderate 3. patient supplies 3. severe 4. blood and body fluids c. emergency medications e. safe injection practices d. radiographer’s response and 4. transmission-based precautions documentation a. contact b. droplet c. airborne 5. additional precautions a. neutropenic precautions (reverse isolation) b. healthcare-associated (nosocomial) infections F. Handling and Disposal of Toxic or Hazardous Material 1. types of materials a. chemicals b. chemotherapy 2. safety data sheet (material safety data sheet) 3  RADIOGRAPHY ARRT BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 2022 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) (Safety continues on the following page.) 4  RADIOGRAPHY ARRT BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 2022 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 * (August 24, 2016) Note: Although it is the radiographer’s responsibility to apply radiation protection principles to minimize bioeffects for both patients and personnel, the ALARA concept is specific to personnel protection and is listed only for that section. 5  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 * Includes conversion factors for grids B. Technique Charts d. matrix size 1. anatomically programmed technique e. modulation transfer function (MTF) 2. fixed versus variable kVp 2. contrast resolution 3. special considerations a. bit depth a. casts b. detective quantum efficiency (DQE) b. pathologic factors c. grids c. age (e.g., pediatric, geriatric) 3. image signal d. body mass index (BMI) a. dynamic range e. contrast media b. quantum noise (quantum mottle) f. grids c. signal to noise ratio (SNR) g. OID E. Image Identification C. Automatic Exposure Control (AEC) 1. methods (e.g., radiographic, 1. effects of changing exposure factors electronic) on radiographic quality 2. legal considerations 2. detector selection (e.g., patient data, examination data) 3. anatomic alignment F. Criteria for Image Evaluation 4. exposure adjustment 1. exposure indicator (e.g., density, +1 or –1) 2. quantum noise (quantum mottle) D. Digital Imaging Characteristics 3. gross exposure error 1. spatial resolution (e.g., loss of contrast, saturation) a. pixel characteristics 4. contrast (e.g., size, pitch) 5. spatial resolution b. detector element (DEL) 6. distortion (e.g., size, shape) (e.g., size, pitch, fill factor) 7. identification markers CCD, CMOS (e.g., size, pitch) (e.g., anatomical side, patient, date) c. sampling frequency (CR) 8. image artifacts 9. radiation fog (CR) 6  RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022 Image Production (continued) 4. accessories a. stationary grids b. Bucky assembly 2. Equipment Operation and c. compensating filters Quality Assurance B. Image Processing and Display A. Imaging Equipment 1. raw data (pre-processing) 1. x-ray generator, transformers and a. analog-to-digital converter (ADC) rectification system b. quantization a. basic principles c. corrections (e.g., rescaling, flat b. phase, pulse and frequency fielding, dead pixel correction) c. tube loading d. histogram 2. components of radiographic unit 2. corrected data for processing (fixed or mobile) a. grayscale a. operating console b. edge enhancement b. x-ray tube construction c. equalization 1. electron source d. smoothing 2. target materials 3. data for display 3. induction motor a. values of interest (VOI) 4. filtration b. look-up table (LUT) c. automatic exposure control (AEC) 4. post-processing 1. radiation detectors a. brightness 2. back-up timer b. contrast 3. exposure adjustment c. region of interest (ROI) (e.g., density, +1 or -1) d. electronic cropping or masking 4. minimum response time e. stitching d. manual exposure controls 5. display monitors e. image receptors a. viewing conditions (e.g., viewing 1. computed radiography (CR) angle, ambient lighting) a. plate (e.g., photo-stimulable b. spatial resolution (e.g., pixel size, phosphor (PSP)) pixel pitch) b. plate reader c. brightness and contrast 2. digital radiography (DR) 6. imaging informatics a. direct conversion a. information systems, (e.g., HIS, b. indirect conversion RIS, EMR, EHR) 1. amorphous silicon (a-Si) b. networking 2. charge coupled device 1. PACS (CCD) 2. DICOM 3. complementary metal c. downtime procedures oxide semiconductor (CMOS) f. beam restriction 3. components of fluoroscopic unit (fixed or mobile) a. image receptors 1. image intensifier 2. flat panel b. viewing systems c. recording systems d. automatic brightness control (ABC) or automatic exposure rate control (AERC) e. magnification mode f. table 7  RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022 Image Production (continued) C. Quality Control of Imaging Equipment and Accessories 1. beam restriction a. light field to radiation field alignment b. central ray alignment 2. recognition and reporting of malfunctions 3. digital imaging receptor systems a. maintenance (e.g., detector calibration, plate reader calibration) b. QC tests (e.g., erasure thoroughness, plate uniformity, spatial resolution) c. display monitor quality assurance (e.g., grayscale standard display function, luminance) 4. shielding accessories (e.g., testing lead apron, gloves) 8  RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022 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. 1. Head, Spine and Pelvis Procedures C. GU Studies A. Head 1. cystography 1. skull 2. cystourethrography 2. facial bones 3. intravenous urography 3. mandible 4. retrograde urography 4. temporomandibular joints 5. hysterosalpingography 5. nasal bones 3. Extremity Procedures 6. orbits A. Upper Extremities 7. paranasal sinuses 1. fingers B. Spine and Pelvis 2. hand 1. cervical spine 3. wrist 2. thoracic spine 4. forearm 3. scoliosis series 5. elbow 4. lumbar spine 6. humerus 5. sacrum and coccyx 7. shoulder 6. myelography 8. scapula 7. sacroiliac joints 9. clavicle 8. pelvis and hip 10. acromioclavicular joints 2. Thorax and Abdomen Procedures B. Lower Extremities A. Thorax 1. toes 1. chest 2. foot 2. ribs 3. calcaneus 3. sternum 4. ankle 4. soft tissue neck 5. tibia/fibula 5. sternoclavicular joints 6. knee/patella B. Abdomen and GI Studies 7. femur 1. abdomen 8. long bone measurement 2. esophagus C. Other 3. swallowing dysfunction study 1. bone age 4. upper GI series, single or double contrast 2. bone survey (e.g., metastatic, 5. small bowel series non-accidental trauma) 6. contrast enema, single or double contrast 3. arthrography 7. surgical cholangiography 8. ERCP 9  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 10  RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022 C. GU Studies 7. Shoulder C. Other 1. Cystography a. AP internal and external 1. Bone Age a. AP rotation 2. Bone Survey b. LPO and RPO b. inferosuperior axial 3. Arthrography c. lateral (Lawrence) d. AP axial c. posterior oblique (Grashey) 2. Cystourethrography d. AP neutral a. AP voiding e. PA oblique (scapular Y) cystourethrogram female f. supraspinatus outlet (Neer) b. RPO voiding 8. Scapula cystourethrogram male a. AP 3. Intravenous Urography b. lateral a. AP, scout, and series 9. Clavicle b. RPO and LPO a. AP or PA c. post-void b. AP axial 4. Retrograde Urography c. PA axial a. AP scout 10. Acromioclavicular Joints – AP b. AP pyelogram bilateral with and without c. AP ureterogram weights 5. Hysterosalpingography B. Lower Extremities 3. Extremities 1. Toes A. Upper Extremities a. AP, entire forefoot I. Fingers b. AP or AP axial toe a. PA entire hand c. oblique toe b. PA finger only d. lateral toe c. lateral e. sesamoids, tangential d. medial and/or lateral 2. Foot oblique a. AP axial e. AP thumb b. medial oblique f. medial oblique thumb c. lateral oblique g. lateral thumb d. lateral 2. Hand e. AP axial weight bearing a. PA f. lateral weight bearing b. lateral 3. Calcaneus c. lateral oblique a. lateral 3. Wrist b. plantodorsal, axial a. PA c. dorsoplantar, axial b. lateral oblique 4. Ankle c. lateral a. AP d. PA–ulnar deviation b. mortise e. PA axial (Stecher) c. lateral f. tangential carpal canal d. medial oblique (Gaynor-Hart) e. AP stress 4. Forearm f. AP weight bearing a. AP g. lateral weight bearing b. lateral 5. Tibia/Fibula 5. Elbow a. AP a. AP b. lateral b. lateral 6. Knee/patella c. lateral oblique a. AP d. medial oblique b. lateral e. AP partial flexion c. AP weight bearing f. trauma axial laterals d. lateral oblique (Coyle) e. medial oblique 6. Humerus f. PA axial–intercondylar a. AP fossa (Holmblad) b. lateral g. PA axial–intercondylar c. neutral fossa (Camp Coventry) d. transthoracic lateral h. AP axial–intercondylar fossa (Béclère) i. PA patella j. tangential (Merchant) k. tangential (Settegast) 7. Femur a. AP b. lateral 8. Long Bone Measurement 11  RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022 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 a. anterior oblique (facing the image receptor) i. left anterior oblique (LAO) body rotated with the left anterior portion closest to the image receptor ii. right anterior oblique (RAO) body rotated with the right anterior portion closest to the image receptor b. posterior oblique (facing the radiographic tube) i. left posterior oblique (LPO) body rotated with the left posterior portion closest to the image receptor ii. right posterior oblique (RPO) body rotated with the right posterior portion closest to the image receptor 2. oblique extremity positions a. lateral (external) rotation from either prone or supine, outward rotation of the extremity b. medial (internal) rotation from either prone or supine, inward rotation of the extremity 12  RADIOGRAPHY ARRT® BOARD APPROVED: JANUARY 2021 CONTENT OUTLINE IMPLEMENTATION DATE: JANUARY 1, 2022 Anteroposterior Projection Posteroanterior Projection Right Lateral Position Left Lateral Position Left Posterior Oblique Position Right Posterior Oblique Position Left Anterior Oblique Position Right Anterior Oblique Position 13 V 2021.02.25