This section is an experiment to evaluate the use of the web as a source of information on radiographic technique your comments are welcome on the message board
The notes do not pertain to be a complete description of all projections possible, rather a selection of the basic most common projections.

The common elements of technique will be present below.

Accessories:
Fine and standard/regular resolution, film speed screen combinations in an assortment of sizes.
Pads and immobilisation aids.
Cones and Plates to fit equipment being used.
Hard surface disinfectant for bucky board or head support.

Anatomical Markers
Anatomical markers placed on the cassette at the time of exposure with the correct PA AP orientation is the preferred standard in general use in the UK. Additional special radio opaque markers may be used in special circumstances. Anatomical markers should be placed in the primary beam away from any relevant anatomical structure and the correct way up / round.

Collimation
Collimation to include the required structures within the size of the film required is generally the best description, reducing the volume of tissue irradiated reduces the dose to the patient.
Evidence of collimation on four sides equally around the centering point 
However collimation may sometimes be compromised by the need to center over a specific point such as a joint space, and include for example the lower third of the tibia and fibula in imaging the ankle, in this case the distal collimation may not be visible and  may be off the film.
Collimation in general should be such that the radiosensitive organs such as the thyroid, eyes, gonads and breasts receive the least dose commensurate with the image required.

Immobilisation
Full immobilisation is essential for high quality diagnostic imaging, the use of supporting devices, Velcro binders and pads will assist in immobilising the patient in most cases.

Indication for Imaging
Will be based on the Royal College of Radiologists Guidelines

FFD Focus to Film Distance
In general radiographic imaging is performed at two common FFD's
100cm and 180cm, in general the 100cm is used for non bucky work where there is little magnification, and 180cm when there is increased risk of magnification, however in bucky work must be performed at the required FFD for the grid involved, this is most commonly between 100 and 130 cm with some specialised skull units using values less than 100cm.

Patient Identification ( Click here for  link to sample policy)
Before starting any examination, the identity of the patient must be checked by the radiographer; a patient may answer to a name not his/her own. If the patient is fully compus mentus, the radiographer should ask the patient their name and date of birth, these must match the request form, Inpatients must have their ID bands checked and they must match the request card.

Patient Preparation
Basic psychological preparation with reassurance and explanation of technique.
Patients referred for radiography may be worried and anxious about the outcome, some patients, are difficult to handle and may need special care, typically the very young, old  physically and or mentally infirm, unconscious or unable to co-operate, The assistance of a nurse or other competent person may be required. An understanding and tolerant attitude exhibited by the radiographer always helps. Time taken to explain the test to the patient is never wasted.
All detachable artifacts must be removed from the image area, long hair must be tied out of the way, if possible monitoring leads /pads should be removed for the duration of the examination.
It is important to remember the dignity of the patient, and essential to have clean hands, a clean cassette or bucky stands and clean immobilisation aids at all times.

Radiation Protection
The 10 or 28 day rule will apply as required (see SP8 in the regulations section)
Methods for reducing doses to patients should be followed at all times.
Where possible beam should be pointed away from the gonads or most radiosensitive organs, there should be direct lead rubber gonad protection whenever possible taking into account the possibility of back scatter from equipment. The most effective method of dose reduction is careful technique to avoid the need for repeat radiographs.


"Kings Lynn" Gonad protection during pelvic imaging (Click here for more details)

Position for female patients

The shaded area is constructed of 2mm of lead

Position for male patients

The shaded area is constructed of 2mm of lead

 

Patient position
Accepted terminology related to the Normal Anatomical Position will apply.

 

Normal Anatomical Position

1 Coronal Plane.    2 Median Saggital Plane.     3Axial Plane
Body Planes
(Bontrager, Textbook of Radiographic Positioning and Related Anatomy, 3rd Edition, Mosby)

Patient / Film Identification
All radiographic images should have the following details legible and actinically marked on the film before processing, Patients name, examination number, date and hospital name, and be placed in the departmentally accepted position away from any anatomical structure of interest.