Portable radiography

Last revised by Andrew Murphy on 30 Jun 2022

Portable radiography (also known as mobile radiography) is frequently performed in hospitals when patients are too unwell to transport to the imaging department. However, most health facilities endeavor to perform "departmental films", as image quality tends to be inferior when performed with a mobile x-ray system 1.

Mobile examinations are requested on patients who are unable to leave the ward for example:

  • intubated
  • medical emergency
  • infectious
  • neutropenic
  • requiring wall-suction

Most often, this projection is conducted on patients who are unable to move on their own and the position will be as the patient is. Therefore inevitably, radiographs are often suboptimal as even a good quality AP projection cannot be done, let alone a PA chest

  • chest radiography
    • AP view: ideally fully erect
      • patient is sat up in bed
    • PA view
      • patient standing or sitting holding the detector up, often done in situations where the patient is well enough to do this but unable to leave the ward i.e. infectious
    • supine view
    • prone view
  • abdominal radiography
    • supine view
    • erect view
  • pelvis radiography
    • AP view
      • often performed in scenarios where patient is unable to be transported to the radiology department i.e. trauma, infectious

Patients will most likely already be in a hospital gown. However, it is still important to check and remove any necklaces, Holter monitors, or ECG leads that cover the area of interest. In cases where ECG leads cannot be removed, they should be repositioned out of the field as much as possible. 

  • if poor radiographic technique is used, the patient's treatment plan may be affected, therefore great care must be taken in order to closely simulate x-rays taken in the imaging department

During the COVID-19 pandemic, portable radiography has become a heavily utilized form of medical imaging. To lessen staff exposure to infectious patients (and keep the machine clean) radiographers can x-ray through the glass of a patient's room with a slight increase to the mAs for a similar (almost the same) image quality 2-5.

  • planning how to x-ray the patient before moving the patient will keep the patient comfortable for as long as possible, thus may increase patient compliance
  • ensure that surrounding staff and patients are not pregnant; if a nearby patient is pregnant, staff will need to move them away temporarily
  • advise all staff and patients to stand as far away as possible during exposure as doubling the distance will halve the scattered radiation dose 1
  • before making an exposure, always produce an audible alert (i.e. "X-ray, Bed number _") to ensure all staff and patients nearby know an x-ray is about to be performed
  • to maintain infection control, pillowcases or plastic bags can be used to cover the detector, and sanitiser wipes used to clean the equipment in between patients

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Cases and figures

  • Case 1: COVID-19 pneumonia
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  • Case 2: esophageal perforation - misplaced nasogastric tube
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  • Case 3: COVID-19 pneumonia and barotrauma complications
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  • Case 4: esophageal temperature probe
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  • Case 5: pneumoperitoneum (pediatric)
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  • Case 6: Post-op (rib plating) for flail segment
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  • Case 7: pneumoperitoneum
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  • Case 8: pelvic osteophytes
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