Radiographic Procedures · ARRT 2025
Trauma, Mobile & Surgical Radiography for the ARRT Exam
Cross-table lateral C-spine to C7-T1, the Danelius-Miller hip, Coyle elbow angles, grid cutoff at the bedside, and C-arm safety rules for the ARRT Radiography exam.
Overview
Trauma, Mobile and Surgical Radiography is routine radiography with the routine taken away. The patient cannot turn and the collar cannot come off, so you adapt the central ray and the receptor instead of the anatomy. Three principles carry every projection: two projections as near 90 degrees apart as the patient allows, the entire structure on the image, and everyone in the room safe.
The chapter runs on substitutions. The cross-table lateral cervical spine, taken with the collar on, must show C1 through the C7-T1 joint space, or a swimmer's lateral follows. The Danelius-Miller hip replaces the frog-leg: receptor parallel to the femoral neck, central ray perpendicular to it. The Coyle elbow flexes 90 degrees, beam 45 degrees toward the shoulder, for the radial head; 80 degrees, beam 45 degrees away, for the coronoid. A knee that cannot turn gets a lateromedial horizontal beam, an abdomen that cannot roll gets the dorsal decubitus, and a lateral decubitus waits 5 minutes so free air can rise.
Mobile work takes away the bucky, the SID detent, and the shielded barrier, so grid errors dominate: off-center, off-level, off-focus, and upside down. A soft mattress tilts the grid by itself. In the operating room the C-arm rule is tube below the table, intensifier above; reversing it can raise the operator's eye dose up to 100 times, and you stand at least 6 feet (2 m) from the tube during exposures.
The ARRT exam pulls hard from here: Procedures is 72 of 200 scored questions, and trauma is where positioning theory meets a patient who cannot cooperate. Add the fracture vocabulary (Colles displaces posteriorly, Smith anteriorly) and the eight principles of surgical asepsis.
What you’ll learn in this chapter
The 39 lessons in this chapter break down as follows. The full lesson content is unlocked when you start a free account.
Trauma, Mobile & Surgical
- Trauma, Mobile and Surgical Radiography
Terminology
- Dislocation, Sprain and the Shape of a Fracture
- Quiz
- Fracture Types by Pattern
- Fractures With a Name Attached
- Quiz
Principles
- The Three Principles of Trauma Positioning
- Backboards, Collars and Who Holds
- Quiz
Mobile radiography
- Working Off the Table
Trauma chest
- The Trauma Chest
- Quiz
Trauma abdomen
- The Trauma Abdomen
- Quiz
Upper limb
- Trauma Upper Limb
- Quiz
Shoulder
- Trauma Shoulder and Proximal Humerus
- Quiz
Lower limb
- Trauma Lower Limb
- Quiz
Pelvis & hip
- Trauma Pelvis and Hip
- Quiz
Cervical spine
- The Cross-Table Lateral Cervical Spine
- Quiz
Thoracic & lumbar spine
- Horizontal Beam Laterals of the Trunk
Cranium & facial bones
- Trauma Cranium and Facial Bones
- Quiz
Surgical radiography
- Sterile, Nonsterile and Where You Stand
The C-arm
- The C-Arm
Surgical procedures
- The Procedures You Will Be Called For
- Quiz
Image critique
- Critiquing a Trauma Image
Clinical indications
- What Is Being Looked For
Recap
- What to Carry Out of This Chapter
- Quiz
- Quiz
- Quiz
- Quiz
- Quiz
Key terms in this chapter
These are the 8 terms most likely to appear on the ARRT registry from this chapter. Use them as a flashcard pre-quiz.
- Danelius-Miller Method
- The axiolateral inferosuperior hip that replaces the frog-leg when a fracture is suspected. The receptor sits against the patient's side parallel to the femoral neck, and the horizontal central ray crosses perpendicular to both.
- Coyle Method
- Axial laterals for the elbow that will not straighten. Flex 90 degrees with the CR 45 degrees toward the shoulder for the radial head; flex 80 degrees with the CR 45 degrees away for the coronoid process.
- Transthoracic Lateral
- The shoulder lateral taken through the thorax when the injured arm cannot move. A breathing technique of at least 3 seconds blurs the ribs and lung markings while the humerus stays sharp.
- Dorsal Decubitus
- A lateral taken with a horizontal beam while the patient stays supine. It replaces the left lateral decubitus abdomen when the patient cannot be rolled, as on an intubated intensive care patient.
- Colles Fracture
- Fracture of the distal radius with the distal fragment displaced posteriorly, typically from a forward fall on an outstretched arm. A Smith fracture is the reverse: anterior displacement from a backward fall.
- Grid Cutoff
- Uneven or overall loss of exposure when the beam and grid misalign: off-center, off-level, off-focus, or upside down. A grid tilted on a soft mattress is the classic bedside cause.
- Surgical Asepsis
- The practice that minimizes infectious agents in the surgical environment. Only sterile items enter the sterile field, doubtful items count as nonsterile, and OR tables are sterile only at tabletop level.
- C-arm
- The mobile fluoroscopy unit used in surgery, with the x-ray tube at one end and the image intensifier at the other. Recommended orientation is tube below the table; scatter from the patient is the main staff exposure source.
Sample practice question: Extremity
One free sample from the 105-question Extremity bank. See the format, the rationale style, and the difficulty before you sign up.
A patient presents with wrist pain after falling on an outstretched hand. The PA, lateral, and oblique wrist projections appear normal but clinical suspicion for scaphoid fracture remains. What additional projection should be performed?
Show answer and rationale
A, Incorrect: The carpal tunnel projection demonstrates the carpal tunnel itself, not the scaphoid in particular.
B, Correct: Correct. The Stecher method (PA wrist with ulnar deviation, central ray angled 20° proximally toward the elbow) elongates the scaphoid and reveals fractures missed on routine PA. It is the standard supplementary view for suspected scaphoid fracture.
C, Incorrect: AP oblique medial rotation is for the elbow, not the wrist. Wrist obliques are routinely lateral rotation.
D, Incorrect: Radial deviation does not elongate the scaphoid. Ulnar deviation is required for the Stecher.
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Frequently asked questions
What does the ARRT Radiography Radiographic Procedures category cover?
Trauma, Mobile and Surgical Radiography is routine radiography with the routine taken away. The patient cannot turn and the collar cannot come off, so you adapt the central ray and the receptor instead of the anatomy. Three principles carry every projection: two projections as near 90 degrees apart as the patient allows, the entire structure on the image, and everyone in the room safe.
How many lessons are in the Trauma, Mobile & Surgical Radiography for the ARRT Exam chapter?
This chapter contains 39 lessons across 19 sections, plus a knowledge-check quiz at the end. The full lesson content is unlocked with a Premium subscription. The free tier includes 3 complete chapters.
Is this chapter aligned with the ARRT 2025 Content Specifications?
Yes. Every chapter on this site maps directly to the ARRT Radiography Content Specifications effective 2025. This chapter falls under the Radiographic Procedures domain of the official ARRT exam blueprint.