Procedures · ARRT Radiography
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 may not be able to turn, and a cervical collar stays on until a physician has cleared the neck, 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 and the shielded barrier, so the grid and the SID become your job, and grid errors are easy to make: off-center, off-level, off-focus, and upside down. The patient's weight on a soft mattress can tilt the grid off level unless you support it. 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.
Procedures carries 66 of 200 scored questions on the 2022 outline, in force until 28 February 2027, and 72 of 200 from 1 March 2027. Both outlines list trauma under procedure adaptation, 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 22 study slides and 17 quiz questions in this chapter break down as follows. 3 chapters are free in full with a free account. The others come with a paid plan, and paid plans open soon.
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 8 key terms from this chapter. Use them as a flashcard pre-quiz.
- Danelius-Miller Method
- The cross-table (horizontal beam) lateral hip, as the 2027 ARRT outline names it, used in place of the frog-leg when a fracture is suspected. The standard text calls it an axiolateral inferosuperior, a label ARRT gives to the Clements-Nakayama method. 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. Bontrager gives it as an alternative to the lateral decubitus when the patient cannot be moved.
- 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 one 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 question from the Extremity subcategory, like those in its 377-question bank. Several chapters share each sample, so it may not match this chapter's topic. 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.
B, Correct: Correct. ARRT and Merrill's call the Stecher method a PA axial scaphoid projection, while Bontrager titles its modified version a PA scaphoid. Both books raise the hand end 20° with a perpendicular CR, and Bontrager adds ulnar deviation. Merrill's also gives a variation with the CR 20° toward the elbow, and Bontrager gives a separate ulnar-deviation method with the CR angled 10° to 15° proximally. Use your program's text. Bontrager notes nondisplaced fractures may still need more projections or CT.
C, Incorrect: This is a real wrist projection, but it shows the medial carpals, not the scaphoid.
D, Incorrect: This is not a scaphoid projection. Radial deviation is its own PA wrist projection, and it shows the medial carpals.
Read 3 chapters free.
The free tier unlocks 3 complete chapters, 50 practice questions, and 1 sample timed exam. No credit card required.
Frequently asked questions
What does the Trauma, Mobile & Surgical Radiography for the ARRT Exam chapter cover?
Trauma, Mobile and Surgical Radiography is routine radiography with the routine taken away. The patient may not be able to turn, and a cervical collar stays on until a physician has cleared the neck, 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 study slides are in the Trauma, Mobile & Surgical Radiography for the ARRT Exam chapter?
This chapter has 22 study slides and 17 quiz questions across 19 sections. The full chapter comes with a paid plan, and paid plans open soon. The free tier includes 3 complete chapters.
Is this chapter aligned with the current ARRT Content Specifications?
Every chapter on this site is mapped to the ARRT Radiography Content Specifications, but our line-by-line check against ARRT's outline isn't finished, so keep ARRT's outline beside it. Nothing here follows your exam date, so check which version applies to you. This chapter falls under the Procedures domain of the official ARRT exam blueprint.