Radiographic Procedures II

Course Description

RTE1513C – Radiographic Procedures II is a 3-credit, integrated lecture-and-laboratory course continuing the radiographic positioning and procedures sequence within Florida Associate in Science (AS) Radiography programs. Building directly on RTE1503C foundations (chest, abdomen, extremities, and basic axial skeleton — covered in the corpus), RTE1513C addresses more complex examinations including the skull and facial bones; advanced spine procedures including specialized projections; pediatric and geriatric considerations at greater depth; introductory contrast-media studies; and substantial laboratory practicum extending student positioning skills to these more challenging examinations. Standard format is 2 lecture hours and 2 laboratory hours per week for 15-16 weeks (60 total contact hours).

The course sits within the Florida Statewide Course Numbering System (SCNS) under Radiography and Medical Imaging > Radiographic Procedures and is offered at approximately 27 Florida public institutions with AS-Radiography programs. RTE1513C completes the foundational positioning sequence in the corpus, paired with RTE1503C (Procedures I) to provide comprehensive coverage of the routine and intermediate radiographic examinations Florida AS-Radiography programs introduce in their first year. Subsequent procedure courses (RTE1523C, RTE2533C, etc.) build on RTE1513C foundations to cover advanced procedures including contrast studies in greater depth, mobile and surgical radiography, trauma radiography, and specialty examinations.

This course continues to follow ARRT (American Registry of Radiologic Technologists) examination content specifications and prepares students for the Radiographer (R) certification examination. As with RTE1503C, this course is delivered only at JRCERT-accredited Florida programs.

Learning Outcomes

Required Outcomes

Upon successful completion of RTE1513C, students will be able to:

• Continue applying principles of patient care and radiation safety at advancing competency level: ALARA principle in more complex examinations; appropriate shielding decisions for the skull, facial, and contrast-study examinations covered; pregnancy precautions in higher-dose examinations; the substantial radiation-safety considerations as procedures complexity increases.
• Perform skull radiography: AP axial (Towne) for occipital bone; PA axial (Caldwell) for frontal bone; lateral skull; SMV (submentovertical) for skull base; the standard skull-radiography series; the substantial reduction in skull radiography volume in contemporary practice as CT has replaced many skull-imaging indications, while maintaining skill competency for circumstances where radiography remains appropriate.
• Perform facial bones radiography: facial bones standard series (PA Waters, lateral, PA Caldwell); orbits (rim and floor); nasal bones (lateral); mandible (PA, axiolateral); zygomatic arches (SMV); temporomandibular joints (TMJ open and closed mouth); the appropriate use of facial-bones radiography given competing CT modalities in contemporary practice.
• Perform paranasal sinuses radiography: standard sinus series (PA Caldwell, Waters, lateral); the upright requirement for sinus radiography (to demonstrate fluid levels); the appropriate use of sinus radiography in contemporary practice.
• Perform advanced cervical spine radiography: dynamic flexion and extension lateral views; the trauma cervical spine series (cross-table lateral, AP, oblique); the appropriate cervical spine series for various clinical indications.
• Perform advanced lumbar spine radiography: dynamic flexion and extension lateral views; spot lumbosacral joint; oblique views with appropriate technical-factor adjustments.
• Perform scoliosis radiography: erect AP scoliosis series; the appropriate technical-factor and shielding considerations for scoliosis screening.
• Perform chest and abdominal radiography at advanced level: the lateral decubitus series; rib radiography (above and below diaphragm series); sternum radiography (oblique RAO and lateral); upper airway radiography (lateral soft-tissue neck for foreign body or airway evaluation).
• Perform pediatric radiography: pediatric immobilization techniques (Pigg-O-Stat, sand bags, parental holding with appropriate radiation-safety precautions); pediatric chest, abdomen, and extremity positioning adjustments; technical-factor adjustments for pediatric patients; the substantial difference in pediatric radiography vs. adult radiography in equipment, technique, and patient management.
• Perform geriatric radiography: positioning adjustments for elderly patients with limited mobility, kyphosis, scoliosis, or osteoporosis; communication adjustments for elderly patients with sensory impairments or cognitive concerns; the substantial role of radiographer accommodation in geriatric care.
• Apply principles of introductory contrast-media studies: contrast-media types (positive: barium sulfate suspensions, iodinated contrast; negative: air); appropriate clinical applications; basic contrast-study procedures (upper GI series, small bowel follow-through, barium enema, esophagram, intravenous urography at survey level — though IVU has been largely replaced by CT in contemporary practice); the patient-care considerations during contrast studies; recognition of contrast reactions at survey level (the actual management of severe reactions is a physician/nurse responsibility, but radiographers must recognize and immediately report).
• Apply principles of positioning terminology and anatomy at advanced level: skull and facial-bone anatomy (sutures, fossae, foramina, sinuses, ossicles); spinal anatomy at advanced level; landmarks specific to skull, facial, and contrast-study positioning.
• Continue applying principles of image evaluation and critique at advanced level: routine evaluation criteria for skull, facial, contrast, and pediatric examinations; the substantial role of accurate image evaluation in patient care quality.
• Recognize common pathology on the examinations covered at introductory level: facial-bone fractures; skull fractures (when present, although note that CT has replaced skull radiography for trauma in contemporary practice); sinusitis (air-fluid levels); spinal abnormalities; common pediatric pathology; common geriatric pathology; the appropriate scope of radiographer pathology recognition.
• Continue demonstrating professional behaviors and ethical practice at advancing competency level.
• Successfully complete laboratory practicum demonstrating positioning competency for each examination type covered.

Optional Outcomes

Depending on institutional emphasis:

• Engage with introductory contrast studies in greater depth: the substantial reduction in contrast-radiography volume in contemporary practice; specific contrast studies still commonly performed (modified barium swallow study for dysphagia evaluation, specific GI studies); the relationship between contrast radiography and CT alternatives.
• Engage with introductory awareness of fluoroscopy: the radiographer role in fluoroscopy assistance; radiation-safety considerations for fluoroscopy; the substantial radiation-dose differences between radiography and fluoroscopy.
• Engage with specialty pediatric considerations: NICU portable radiography; child-life specialist collaboration; pediatric-trauma considerations.
• Engage with introductory awareness of dental radiography at survey level: panoramic and cephalometric radiography awareness; the relationship between medical and dental radiography practice.

Major Topics

Required Topics

• Patient Care and Radiation Safety (Continued): ALARA in more complex examinations; appropriate shielding for skull, facial, contrast-study examinations; pregnancy precautions in higher-dose examinations; advancing radiation-safety considerations.
• Skull Radiography: AP axial (Towne) for occipital; PA axial (Caldwell) for frontal; lateral skull; SMV (submentovertical) for skull base; standard skull-radiography series; contemporary reduction in skull radiography volume due to CT replacement.
• Facial Bones Radiography: Standard facial-bones series (PA Waters, lateral, PA Caldwell); orbits (rim and floor); nasal bones (lateral); mandible (PA, axiolateral); zygomatic arches (SMV); TMJ (open and closed mouth); appropriate contemporary use given CT alternatives.
• Paranasal Sinuses: Standard sinus series (PA Caldwell, Waters, lateral); upright requirement for sinus radiography (to demonstrate fluid levels); contemporary use.
• Advanced Cervical Spine: Dynamic flexion and extension lateral views; trauma cervical spine series (cross-table lateral, AP, oblique); appropriate cervical spine series for various clinical indications.
• Advanced Lumbar Spine: Dynamic flexion and extension lateral views; spot lumbosacral joint; oblique views with appropriate technical-factor adjustments.
• Scoliosis Radiography: Erect AP scoliosis series; appropriate technical-factor and shielding considerations.
• Advanced Chest and Abdominal Radiography: Lateral decubitus series; rib radiography (above and below diaphragm series); sternum radiography (oblique RAO and lateral); upper airway radiography (lateral soft-tissue neck).
• Pediatric Radiography: Immobilization techniques (Pigg-O-Stat, sand bags, parental holding); pediatric chest, abdomen, extremity positioning adjustments; technical-factor adjustments for pediatric patients.
• Geriatric Radiography: Positioning adjustments for limited mobility, kyphosis, scoliosis, osteoporosis; communication adjustments; substantial role of accommodation in geriatric care.
• Introductory Contrast-Media Studies: Contrast-media types (positive: barium sulfate, iodinated contrast; negative: air); clinical applications; basic procedures (upper GI series, small bowel follow-through, barium enema, esophagram, IVU at survey level); patient-care considerations; contrast-reaction recognition at survey level.
• Positioning Terminology and Anatomy at Advanced Level: Skull and facial-bone anatomy (sutures, fossae, foramina, sinuses, ossicles); spinal anatomy at advanced level; landmarks specific to advanced procedures.
• Image Evaluation and Critique at Advanced Level: Routine evaluation criteria for skull, facial, contrast, and pediatric examinations; image-evaluation/patient care quality relationship.
• Common Pathology: Facial-bone fractures; skull fractures (when present, noting CT replacement for trauma); sinusitis (air-fluid levels); spinal abnormalities; common pediatric pathology; common geriatric pathology.
• Professional Behaviors (Continued): Continued advancement at advancing competency level.
• Laboratory Practicum: Positioning competency demonstration for each examination type covered.

Optional Topics

• Contrast Studies (Greater Depth): Substantial reduction in contrast-radiography volume in contemporary practice; specific contrast studies still commonly performed (modified barium swallow for dysphagia, specific GI studies); contrast/CT relationship.
• Fluoroscopy (Introductory): Radiographer role in fluoroscopy assistance; radiation-safety considerations; substantial radiation-dose differences.
• Specialty Pediatric Considerations: NICU portable radiography; child-life specialist collaboration; pediatric-trauma considerations.
• Dental Radiography (Survey): Panoramic and cephalometric radiography awareness; medical/dental radiography practice relationship.

Resources & Tools

• Most-adopted textbooks at Florida institutions: Continuation of textbook used in RTE1503C — Merrill's Atlas of Radiographic Positioning & Procedures by Long, Rollins, Smith (Elsevier); Bontrager's Handbook of Radiographic Positioning and Techniques by Lampignano, Kendrick (Elsevier); Textbook of Radiographic Positioning and Related Anatomy by Bontrager, Lampignano (Elsevier); Radiographic Pathology for Technologists by Mace, Kowalczyk (Elsevier).
• Reference resources: ARRT Examination Content Specifications for Radiography (free, arrt.org); ASRT educational resources; JRCERT program standards.
• Florida regulatory framework: Same as RTE1503C — Florida Department of Health Bureau of Radiation Control under FAC Chapter 64E-3 and Florida Statutes Chapter 468 Part IV.
• Lab equipment (institution-provided): Energized x-ray laboratories; phantoms representing skull, facial bones, and other body parts covered; image-receptor systems; PACS workstations; pediatric-positioning equipment (Pigg-O-Stat, sand bags); contrast-media equipment for demonstration purposes.
• Industry credentials: Continued preparation for ARRT Registered Technologist (Radiography) — R(R) credential at program completion.
• Online resources: Various YouTube channels providing positioning content; ARRT examination-preparation resources; commercial board-review platforms.
• Tutoring and support: Same as RTE1503C — institution radiography skills labs; peer mentoring; clinical instructors and preceptors at clinical sites.

Career Pathways

RTE1513C completion is part of the AS-Radiography sequence; career pathways are realized at AS-Radiography program completion. See the RTE1503C guide for the comprehensive career-pathway overview, which is directly applicable. Specific considerations for RTE1513C content:

• Pediatric Radiography Specialty (with additional experience and training) — Florida pediatric hospitals (Nicklaus Children's, Wolfson Children's, Johns Hopkins All Children's) and pediatric units within general hospitals offer pediatric-specialty radiography roles.
• Trauma and Emergency Radiography — substantial Florida demand at major trauma centers (Level I and II) including JFK Medical Center, Tampa General Hospital, Memorial Regional Hospital, Jackson Memorial Hospital, Orlando Health, and others. Trauma-center radiography requires strong foundational skills covered in RTE1503C and RTE1513C.
• Surgical Radiography — work in operating rooms and interventional procedures; typically pursued after gaining substantial general-radiography experience.
• Specialty Procedures — TMJ imaging; specialty orthopedic imaging; the niche specialties supported by RTE1513C content.

Special Information

Articulation and Transfer

Same as RTE1503C — RTE1513C is part of the limited-access AS-Radiography sequence at Florida institutions and articulates within the Florida public-college system per SCNS conventions.

Florida Radiography Licensure Framework

Same as RTE1503C — Florida regulates radiologic technologists through the Florida Department of Health Bureau of Radiation Control under Florida Administrative Code Chapter 64E-3 and Florida Statutes Chapter 468 Part IV.

Prerequisites

Standard prerequisites typically include:

• RTE1503C (Radiographic Procedures I) with grade of C or higher — non-negotiable; RTE1513C builds directly on the foundational positioning, anatomy, and procedure-execution competencies developed in RTE1503C
• Continued enrollment in the AS-Radiography program in good academic standing
• Continued maintenance of CPR/BLS certification, immunizations, background screening, and other clinical-readiness requirements

Course Format and Workload

Same as RTE1503C — 3-credit integrated lecture-and-laboratory course meeting 2 lecture hours and 2 laboratory hours per week for 15-16 weeks (60 total contact hours). Out-of-class workload typically runs 6-9 hours per week, with substantial study of skull and facial-bone anatomy (the most demanding anatomy content in the foundational radiography sequence).

Course Code Variations

Florida institutions consistently use RTE1513C for this course. Course titles include "Radiographic Procedures II" and "Radiographic Positioning II." All formats cover similar content aligned to ARRT examination content specifications.