EXAMINATION CONTENT SPECIFICATIONS IMPLEMENTATION …

EXAMINATION CONTENT SPECIFICATIONS

ARRT BOARD APPROVED: PENDING IMPLEMENTATION DATE: JANUARY 1, 2023

1 COPYRIGHT© 2021 BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS ALL RIGHTS RESERVED. REPRODUCTION IN WHOLE OR PART IS NOT PERMITTED WITHOUT THE WRITTEN CONSENT OF THE ARRT.

Registered Radiologist Assistant The purpose of the Registered Radiologist Assistant (R.R.A.) examination requirement is to assess whether individuals have obtained the knowledge and cognitive skills underlying the intelligent performance of the tasks typically required of Registered Radiologist Assistants (R.R.A.s) for practice at entry into the profession level. The tasks typically performed were determined by administering a comprehensive practice analysis survey to a nationwide sample of radiologists and radiologist extenders.1 The Registered Radiologist Assistant Entry-Level Clinical Activities (ELCA) inventory may be found on the ARRT’s website (www.arrt.org). The Examination Content Specifications for the Registered Radiologist Assistant identifies the knowledge areas underlying performance of the tasks on the Registered Radiologist Assistant Entry-Level Clinical Activities (ELCA) inventory. Every content category can be linked to one or more activities on the ELCA inventory. The ARRT avoids content when there are multiple resources with conflicting perspectives. Educational programs accredited by a mechanism acceptable to ARRT offer education and experience beyond the minimum requirements specified in the content specifications and clinical competency requirements documents. This document is not intended to serve as a curriculum guide. Although ARRT programs for certification and registration and educational programs may have related purposes, their functions are clearly different. Educational programs are generally broader in scope and address the subject matter that is included in these content specifications, but do not limit themselves to only this content. The following table below presents the major content categories and subcategories covered on the examination. The number of selected response test questions in each category are listed in bold and number of test questions in each subcategory in parentheses. Specific topics within each category are addressed in the content outline, which makes up the remaining pages of this document. In addition, the case study essay section of the examination requires candidates to respond to essay questions concerning the procedures listed in Attachment A, which can be found at the end of this document.

Content Categories Selected Response

Points Case Study

Points1 Patient Care 5660

Patient Management (3834) Pharmacology (1826)

Safety 2825 Patient Safety, Radiation Protection and Equipment Operation2 (2825)

Procedures3 116115 Abdominal Section (4143) Thoracic Section (2529) Musculoskeletal and Endocrine Sections (2520) Neurological, Vascular, and Lymphatic Sections (2523)

Total Number4 200 Testing Time Allowed 3.5 hours 2.5 hours

http://www.arrt.org/

CONTENT SPECIFICATIONS

ARRT BOARD APPROVED: PENDING EFFECTIVE DATE: JANUARY 2023

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1 A special debt of gratitude is due to the hundreds of professionals participating in this project as committee members, survey

respondents, and reviewers. The examination contains two case studies from the list of procedures on Attachment A. Each case is followed by four to six essay

questions worth 3 or 6 points each. A case may also include a few selected response questions (e.g., multiple choice). Refer to Overview of CBT at www.arrt.org for additional details.

2 SI units are thewill become the primary (principle) units of radiation measurement used on the R.R.A. examination. in July, 2018. 3 The Procedures section includes patient assessment and pathophysiology. Procedures may also refer to appropriate imaging. 4 The exam includes an additional 320 unscored (pilot) questions.

REGISTERED RADIOLOGIST ASSISTANT CONTENT OUTLINE


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Patient Care

1. Patient Management1

A. Ethics1. AHA Patient Care Partnership

(Patients’Patient’s Bill of Rights)2. informed consent and patient

education (e.g., informed, oral,implied)a. patient competence

1. cognitive impairment2. competence assessment3. mental status4. medication

b. surrogate consent1. health care power of attorney2. family

c. informed consent components1. explanation of procedure2. risk versus benefit3. alternatives and options to

current procedure4. refusal of procedure and

implications5. radiation exposure and

cumulative dose educationd. pre- and post-procedure care

instructions3. definitions

a. moralsb. valuesc. ethics

3. ASRT Practice Standards4. ARRT Standards of Ethics

B. Medical Law1. definitions

a. negligence and malpractice1. gross2. contributing

b. standard of carec. assault and batteryd. false imprisonmente. slander and libelf. elements of tort law

2. legal doctrinesa. respondeat superiorb. res ipsa loquiturc. foreseeabilityd. personal liabilitye. Good Samaritan Lawf. burden of proofg. borrowed servant

1 Includes adaptations for pediatric, geriatric, and special needs populations.

C. Patient Communication1. psychosocial support

a. communication skills and issuesb. cultural awarenessc. social support structures

2. patient interviewa. verification

1. patient identification andcorrect procedure

2. patient preparation3. pregnancy status

b. medical history1. chief complaint2. present illness3. past medical/surgical/

psychological history4. family history5. personal and social history6. review of systems7. medications (*e.g., prescribed,

OTC, natural)8. allergy history

3. factors affecting communicationa. speech, hearing and language

abilityb. cognitive disordersc. drug and/or alcohol effects

D. Medical Data Review1. indications for procedure (e.g., ACR

Appropriateness Criteria®)2. contraindications for procedure3. laboratory values4. prior diagnostic studies5. current medications6. previous history (e.g., vital signs,

practitionernurses/physicians notes)7. assessment of vital signs, height,

and weight8. physical and/or mental

limitationsdisabilitiesE. Psychological and Cognitive Status

1. cognitive abilities2. emotional stability

* The abbreviation “e.g.,” is used to indicate that examplesare listed in parenthesis, but that it is not a complete list of allpossibilities.

(Patient Care continues on the following page.)



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Patient Care (continued) F. Patient Monitoring and Assessment

(prior to, during, and post-procedure)1. physical status2. emotional status3. cardiac and pulmonary monitoring4. sedation and/or pain control5. medical emergencies

a. cardiac arrestb. hyper/hypoglycemiac. seizured. respiratory arreste. shockf. stroke

G. Common Laboratory Tests, Analysis,and Significance1. CBC2. electrolytes (sodium, potassium,

bicarbonate, chloride, calcium)3. pancreatic and cardiac enzymes4. albumin and total protein5. coagulation profile6. liver function7. renal function8. glucose9. culture and sensitivity

10. cytology and histopathologyH. Infection Control

1. asepsis and sterile techniquea. medical asepsisb. sterile technique (e.g., patient

preparation, procedural tray,maintenance of sterile fields)

2. CDC standard precautions (includingmechanisms of disease transmission)

I. Intravenous Therapy1. venipuncture2. flow rate monitoring3. complications

J. Oxygen Therapy1. level (flow rate)2. devices3. indications and contraindications

K. Urinary Catheterization1. technique2. complications3. contraindications

L. Procedure Complications (Non-Contrast)1. infection2. hemorrhage3. pneumothorax4. perforation (GI or GU)5. respiratory distress6. aspiration7. vasovagal reaction8. pulmonary edema9. vascular injury or occlusion

10. seizures11. pain12. neurologic deficit13. stroke14. cardiac arrest15. radiation injury16. physical injury17. death

M. Medical Records1. components of documentation

a. types of documentation forpatient chart

b. electronic and paper recordsc. fluoroscopic and image

documentation2. techniques and procedures for

documentation3. document development and

administrationa. examination findingsb. exceptions from established

protocol or procedurec. patient’s questions and concernsd. information regarding patient care,

the procedure, and final outcomee. diagnostic/therapeutic procedure

and patient dataf. radiologists’ reports to referring

physiciang. direct communication with referring

physicianh. discharge summaryi. incident reports




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Patient Care (continued)

2. Pharmacology

A. Terminology1. regulations

a. Food and Drug Administration (FDA)b. Drug Enforcement Agency (DEA)c. controlled substances

2. identifying namesa. genericb. tradec. United States Pharmacopoeia (USP)

3. drug characteristicsa. actionsb. synergismsc. side effectsd. adverse reactions

4. dosagea. loadingb. maintenancec. therapeutic dosed. lethal dose

5. safe dosage calculationa. ratiob. proportionc. pediatricd. geriatric

6. administration (e.g., oral, rectal,intravenous)

7. adverse event

B. General Medications: Classifications,Indications, and Contraindications2

1. anti-infective drugsa. antibioticsb. antiviralc. antifungals

2. cardiovascular drugsa. antihypertensive

1. calcium channel blockers2. beta blockers3. ACE inhibitors

b. vasoconstrictorsc. vasodilatorsd. anti-arrhythmicse. vascular drugs

1. coagulation modifiers2. thrombolytics

3. gastrointestinal drugsa. anti-reflux agentsb. hypomotility (glucagon)c. cholecystokinetic

(sincalidecholecystokinin)d. antiemetics

4. anti-inflammatory drugsa. analgesicsb. nonsteroidal anti-inflammatory

drugs (NSAIDs)c. corticosteroids

5. endocrine drugsa. diabetic medicationb. anti-hypoglycemic (glucagon)c. insulind. thyroid medications

6. diuretics7. neurologic and psychotropic drugs

a. anticonvulsantsb. antiparkinsonians


2 Includes indications, contraindications, adverse reactions, dosage, routes of administration, and excretion process.



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Patient Care (continued)

C. Anesthetics and Sedation1. local anesthetics2

a. short actingb. long acting

2. moderate/conscious sedationa. American Society of Anesthesiologists

(ASA) definitionsb. ASA guidelines

1. history and physical2. intra-procedure3. post-procedure4. discharge scoring system

a. motor activityb. respirationsc. standing blood pressured. consciousnesse. oxygen saturation

c. equipmentc. medications2

1. fentanyl2. morphine3. meperidine4. diazepam5. midazolam6. lorazepam7. naloxone8. flumazenil

D. Contrast Media (ACR Manual onContrast Media)1. agents2

a. negative contrast agents (e.g., air,CO2, water)

b. positive contrast agents1. barium sulfate2. iodinated contrast media

a. osmolalityb. molecular structure

c. MRI agents2. contrast related complications

a. nephrotoxicityb. NSF (nephrogenic systemic fibrosis)c. extravasationd. allergies

1. allergy history2. types of reactions (mild to severe)3. premedications

a. diphenhydramineb. corticosteroids

4. anaphylaxis3. resuscitation

a. life support1. basic life support (BLS)2. advanced cardiac life support

(ACLS)b. basic drugs2

1. epinephrine2. atropine3. bronchodilator4. nitroglycerine5. intravenous fluid

2 Includes indications, contraindications, adverse reactions, dosage, routes of administration, and excretion process.



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Safety

1. Patient Safety, Radiation Protection,and Equipment OperationA. Exposure and Dose

1. exposure2. absorbed dose, equivalent dose,

effective dose3. measurement and calculation of

quantities (e.g., CTDI, DAP, kermaarea product)

4. high dose exams and modalitiesB. Safety Standards

1. organizations and their rolesa. American College of Radiology

(ACR)1. Practice Parameters and

Technical Standards 2. Appropriateness Criteria®3. Contrast Manual

b. Nuclear Regulatory Commission(NRC)

c. Occupational Safety and HealthAdministration (OSHA)

d. Environmental Protection Agency(EPA)

e. Food and Drug Administration (FDA)f. International Commission on

Radiological Protection (ICRP)g. National Council on Radiation

Protection and Measurements (NCRP)h. state health departments

2. monitoring and measuringa. personnel dosimetryb. environmentc. devices

3. effective dose limitsbenchmarkingpatient radiation dosea. NCRP reportsb. ACR Appropriateness Criteria®

c. diagnostic reference levelsd. radiation safety resources (e.g.,

Image Wisely®, Image Gently ®,radiologyinfo.org)

C. Methods to Reduce Patient Exposure1. intermittent fluoroscopy2. limitation of field size3. exposure factors (x ray and CT)4. geometry (e.g., SID, SSD, angulation,

table height)5. filtration of the x-ray beam6. protective shielding vary beam

angulation7. immobilization8. grid selection and/or removal9. limitation of fluoroscopic time

10. proper fluoroscope usea. last image holdb. cumulative timerc. magnification moded. dose mode

1. low dose2. cine3. high-level control4. pulsed

11. pediatric considerationsD. Methods to Reduce Occupational

Exposure (e.g., ALARA)1. time and location in radiation area2. shielding devices in x-ray rooms3. personal shielding devices4. proper fluoroscope use

E. Radiation Biology1. cell growth and division2. radiosensitivity of cells

a. direct and indirect effectsb. linear energy transfer (LET)c. relative biological effectiveness

(RBE)d. oxygen enhancement ratio (OER)e. dose rate, fractionation, and protraction

3. radiation effectsa. deterministic (tissue reactions) and

stochastic effectsb. background radiationc. dose-response relationshipsd. skin effectse. acute radiation syndromesf. local tissue damageg. hematological effectsh. carcinogenesisi. fetal effectsj. genetic effects

(Safety continues on the following page.)



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Safety (continued)

F. Regulations1. quality assurance management

a. facility rulesb. The Joint Commission requirements

2. credentialinga. institutional local or hospital

requirementsb. state licensing/registration

regulationsc. supervisory requirementsd. professional standards

3. government regulationsa. Medical Practice Act – supervisory

requirementsb. Health Insurance Portability and

Accountability Act (HIPAA)c. MQSA Act –

1. personnel requirements2. reporting and data system (BI-RADS)

G. Equipment Operation1. fluoroscopy

a. components1. x-ray tube2. image receptors3. collimators4. recording devices (e.g., digital

cameras, cine)5. generator6. controls7. display8. automatic exposure rate

control (AERC)b. static image storagec. dynamic image storaged. pulsed fluoroscopye. high-level or boost modef. exposure factorsg. cumulative timerh. common artifacts (e.g., recursive

filtration, DSA)2. dose monitoring equipment:

cumulative air kerma and dose ratedisplay

H. MRI Safety1. screening and education (patients,

personnel, non-personnel)a. biomedical implantsb. ferromagnetic foreign bodiesc. medical conditions

(e.g., renal function, pregnancy)d. prior diagnostic or surgical procedurese. topical or externally applied items

(e.g., tattoos, medication patches,body piercing jewelry, monitoringdevices, handcuffs)

2. equipment safetya. ancillary equipment in proximityb. designated safety zonesc. emergency response (e.g., fire

fighters, rapid response team,other emergency services)

d. FDA labeling criteria1. Safe2. Conditional3. Unsafe

I. Quality Improvement and Research1. continuous quality improvement (CQI)2. statistics

a. measures of frequencyb. measures of central tendencyc. measures of variation

3. clinical study design4. clinical trial phases



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Procedures

Each section may include questions related to the following topics: • Anatomy and Physiology: normal, age-related changes, and common surgical changes.• Patient Assessment: review medical history, perform a physical examination, evaluate test results,

vital signs, signs, and symptoms.• Procedures: patient and procedure preparation, consent (indications, contraindications, alternatives),

performance, image evaluation and post-processing*, and post procedure outcomes assessment.• Medical Devices: image appearance, indications, purpose, appropriate location, complications.• Pathophysiology: alteration in function and structure related to disease/injury, compensation

mechanisms, and congenital and developmental abnormalities.

*Post processing includes:CT & MRI Image Post-Processing

• 3D reconstruction• maximum intensity projection (MIP)• multiplanar reconstruction (MPR)• quantitative measurements (volume, distance, diameter)• volume rendering

CT Post-Processing • modifications to field of view (FOV)• slice spacing• algorithm• cardiac analysis (e.g., calcium scoring, coronary artery mapping, TAVR)

1. Abdominal Section

A. General Abdomen1. anatomy and physiology2. patient assessmentpre-procedure

rectal examb. signs and symptoms

3. related proceduresa. paracentesisb. abscess, fistula, or sinus tract studyc. percutaneous drainage with or

without placement of catheterd. change of percutaneous tube or

drainage cathetere. removal of percutaneous drainage

cathetere. liver biopsy

4. medical devices (image appearance,indications, purpose, appropriatelocation, and complications)a. drainage cathetersb. peritoneal dialysis cathetersc. stentsd. umbilical vascular catheterse. IVC filter

5. pathophysiologya. abdominal aortic aneurysmb. abdominal calcificationsc. abscessd. free fluid/ascitese. hemoperitoneumf. normal and abnormal gas patternsg. peritonitish. pneumatosis intestinalis

i. pneumoperitoneumj. portal venous gas

B. Gastrointestinal1. anatomy and physiology2. patient assessment23.related procedures

a. esophageal studyb. swallowing function studyc. upper GI studyd. small bowel studye. enema with barium, air, or water

soluble contrastf. postoperative GI study. CT colonographyg. percutaneous, nasogastric/enteric

and orogastric/enteric tubeplacementevaluation

h. nasogastric/enteric andorogastric/enteric tube placement

34. medical devices (image appearance,indications, purpose, appropriatelocation, and complications)a. bariatric devicesb. gastroenteric tubesc. gastrointestinal tract stents

(Procedures continues on the following page.)

Pre procedure exams, signs and symptoms moved to Patient Assessment definition at beginning of Procedure section.

Moved to Medical Devices definition at beginning of Procedure section.

Moved to Medical Devices definition at beginning of Procedure section.



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*post-processing includes:

CT & MRI Image Post-Processing • 3D reconstruction

• maximum intensity projection (MIP)• multiplanar reconstruction (MPR)• quantitative measurements (volume,

distance, diameter) • volume rendering

• CT Post-Processing• modifications to field of view (FOV)• slice spacing• algorithm• cardiac analysis (calcium scoring and

coronary artery mapping)

Moved to definitions at beginning of Procedure section.



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Procedures (continued)

45. pathophysiology – esophagus andstomacha. achalasiab. Barrett esophagusc. bezoard. Crohn diseasee. diverticula (Zenker, Killian-Jameson,

epiphrenic)f. dysphagiag. esophagitish. fistulaei. gastric outlet obstructionj. gastritisk. gastroesophageal reflux disease

(GERD)l. gastroparesism. hiatal herniasn. malignant and benign masseso. presbyesophagusp. primary muscular and neural disordersq. pyloric stenosisr. sclerodermas. surgical variation (e.g., Roux-en-Y,

gastric band, Nissen fundoplication,gastric sleeve)

t. ulcersu. varicesv. volvulusw. webs

56. pathophysiology – small and largeintestinea. adhesionsb. appendicitisc. colitisd. constipatione. Crohn diseasef. diverticulosis/diverticulitisg. duodenitish. fistulaei. herniasj. Hirschsprung diseasek. ileusl. infectionsm. inflammatory bowel syndromen. inflammatory diseaseso. intussusceptionp. ischemiaq. malabsorptionr. malignant and benign tumors

(masses)s. malrotationt. Meckel diverticulumu. necrotizing enterocolitisw. obstructionx. peptic ulcer disease

y. polypsz. superior mesenteric artery (SMA)

syndromeaa. surgical variation bb. toxic megacolon cc. volvulus

C. Hepatobiliary, Pancreas, and Spleen1. anatomy and physiology2. patient assessment3. related procedure:

a. liver biopsy (non-targeted)b. t-tube cholangiogram

4. medical devicesa. stentsb. cholecystostomy tubesc. biliary drainage tubes

5. pathophysiologya. biliary calculib. biliary dyskinesiac. cholangitisd. cholecystitise. cirrhosisf. hepatic steatosisg. hepatitish. liver failurei. malignant and benign massesj. pancreatic insufficiencyk. pancreatic pseudocystl. pancreatitism. portal hypertensionn. splenomegaly

D. Urinary1. anatomy and physiology2. patient assessment3. related procedures

a. antegrade urography(e.g., nephrostography)

b. loopography (urinarydiversionneobladder study)

c. retrograde urethrography orurethrocystography

d. voiding cystography/cystourethrography

4. medical devices (image appearance,indications, and purpose)a. urinary cathetersb. nephrostomy tubesc. ureteral stentsd. artificial urinary sphincter

5. pathophysiologya. acute and chronic renal failureb. calculic. glomerulonephritis and nephrotic

syndrome



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d. infarcts, ischemia, thrombosise. infectious and inflammatory

processesf. malignant and benign massesg. nephrocalcinosish. polycystic kidney diseasei. renal papillary necrosisj. UPJ obstruction (congenital, adult)k. vesicoureteral reflux

E. Reproductive1. anatomy and physiology2. patient assessment3. related procedure: hysterosalpingography4. medical devices

a. penile implantsb. pessaryc. contraceptive devices

5. pathophysiologya. female

1. ectopic pregnancy2. endometriosis3. infertility4. malignant and benign masses5. pelvic inflammatory disease6. polycystic ovary disease7. pregnancy

b. male1. benign prostatic hypertrophy2. hydrocele3. inflammatory processes4. malignant and benign masses5. testicular torsion

4. medical devices (image appearance,indications, and purpose)

a. penile implantsb. pessaryc. contraceptive devices

2. Thoracic SectionA. General Thoracic

1. anatomy and physiology2. patient assessment3. related procedures: chest fluoroscopy4. pathophysiology

a. calcificationb. diaphragmatic paresisc. inflammatory and infectious

diseasesd. malignant and benign massese. pneumomediastinum

B. Cardiac1. anatomy and physiology2. patient assessment

a. perfusion statusb. electrocardiogram (ECG)

3. signs and symptoms

3. medical devices (image appearance,indications, purpose, appropriatelocation, and complications)a. IABP/heart assist deviceb. pacers/AICDc. cardiovascular valvesd. Swan-Ganz catheterse. central venous cathetersf. stents

4. pathophysiologya. cardiac dysrhythmiasb. congestive heart failure (CHF)c. coronary artery diseased. endocarditise. pericardial diseasef. valvular heart disease

C. Pulmonary1. anatomy and physiology2. patient assessment: oxygen

saturation measurement3. signs and symptoms3. related procedures

a. thoracentesisb. placement of catheter for

pneumothorax4. medical devices (image appearance,

indications, purpose, appropriatelocation, and complications)a. chest tubesb. tracheal tubesc. vascular coils

5. pathophysiologya. adult respiratory distress syndrome

(ARDS)b. asthmac. atelectasisd. bronchopulmonary dysplasia

(BPD)e. chronic obstructive pulmonary

disease (COPD)f. malignant and benign massesg. neonatal respiratory distress

syndromeh. pleural diseasesi. pleural effusionsj. pneumothoraxk. pulmonary edemal. pulmonary embolim. pulmonary fibrosisn. pulmonary venous and arterial

hypertension


ECG, perfusion status, signs and symptoms moved to Patient Assessment definition at beginning of Procedure section.



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D. Breast and Axilla1. anatomy and physiology2. patient assessment3. signs and symptoms3. related procedures:

a. injection for sentinel node localizationb. breast needle localizationc. breast imaging - reporting and datasystem (BI-RADS)

4. medical devices (image appearance,indications, purpose, appropriate location,and complications):a. breast implantsb. tissue expanderc. radiofrequency devices

5. pathophysiologya. benign and malignant masses

1. cysts2. ductal carcinoma in situ3. fibroadenoma4. inflammatory breast cancers5. invasive ductal carcinoma6. invasive lobular carcinomas7. Paget disease8. phyllodes

b. inflammatory diseases3. Musculoskeletal and Endocrine Sections

A. Musculoskeletal1. anatomy and physiology2. patient assessment3. signs and symptoms3. related procedures

a. therapeutic bursa aspiration and/orinjection

b. diagnostic joint aspirationc. therapeutic joint injectiond. superficial soft tissue mass biopsye. arthrogram (radiography, CT, MRI)

1. shoulder2. elbow3. wrist4. hip5. knee6. ankle

4. medical devices (image appearance,indications, purpose): orthopedichardware

5. pathophysiologya. arthritis

1. gout2. osteoarthritis3. rheumatoid arthritis4. ankylosing spondylitis5. psoriatic arthritis6. septic arthritis

b. bursitisc. trauma

1. fractures2. dislocations3. associated soft tissue injuries

(e.g., labral tears, meniscustears, tendon tears, effusions)

d. tumors1. chondrosarcoma2. enchondroma3. Ewing sarcoma4. metastatic disease5. multiple myeloma/

plasmacytoma6. osteochondroma7. osteoid osteoma8. osteosarcoma

e. infections1. osteomyelitis2. soft tissue infection

f. diseases1. fibrous dysplasia2. osteogenesis imperfecta3. osteomalacia4. osteoporosis5. Paget disease6. renal osteodystrophy

B. Endocrine1. anatomy and physiology2. patient assessment3. related procedurestudy: thyroid

biopsy4. medical devices: insulin pumps5. pathophysiology

a. adrenal disordersb. diabetes mellitusc. hyperparathyroidismd. pituitary disorderse. renovascular hypertensionf. thyroid disorders

1. malignant and benign masses2. hypo and hyperthyroidism3. inflammatory


Moved Bi-Rads to Safety 1.F.3.c



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4. Neurological, Vascular, andLymphatic SectionsA. Neurological

1. anatomy and physiology2. patient assessment3. signs and symptoms3. related procedures

a. lumbar punctureb. myelogram

1. cervical2. thoracic3. lumbar

4. medical devicesa. image appearance, indications,

and purposea. CSF shuntsb. intrathecal cathetersc. neuro stimulatorsd. embolization devicese. orthopedic hardware

5. pathophysiologya. amyotrophic lateral sclerosis (ALS)b. cerebrovascular accident (CVA)c. Chiari malformationd. dementia (e.g., Alzheimer disease)e. herniated discf. hydrocephalusg. increased intracranial pressureh. infection/inflammationi. intracranial hemorrhagej. malignant and benign massesk. multiple sclerosis (MS)l. myasthenia gravism. normal pressure hydrocephalus (NPH)n. open and closed head injurieso. Parkinson diseasep. pseudotumor cerebriq. seizuresr. spinal cord injurys. syrinxt. tethered cord

B. Vascular and Lymphatic1. anatomy and physiology2. patient assessment3. signs and symptoms of vessel

diseasearterial occlusion andinsufficiency

4. signs and symptoms of venousobstruction and insufficiency

4. related proceduresa. extremity venographyb. superficial lymph node biopsyc. insertion of non-tunneled central

venous catheterd. insertion of tunneled central

venous catheterd. central venous catheter or port

injectione. peripherally inserted central

catheter (PICC) placementf. tunneled venous catheter removal

5. medical devicesa. cathetersb. stentsc. embolization devicesd. IVC filterse. umbilical vascular catheters

6. pathophysiologya. anemiasb. aneurysmc. arterial venous malformations

(AVM)d. arteriosclerosis/atherosclerosise. blood clotting disordersf. coarctation of aortag. deep vein thrombosish. dissectioni. hemorrhagej. hypertensionk. infectious or inflammatory

lymphadenopathy (e.g., cat scratchdisease)

l. leukemiasm. lymphedeman. lymphomaso. shockp. venous insufficiency


ARRT BOARD APPROVED: JULY 2017 IMPLEMENTATION DATE: JULY 1, 2018

15 V 2021.7.09

Attachment A

Two of the following 13 procedures (identified as mandatory on Form CR-1 Summary of Clinical Experience and Competence Assessments) will be included in the

Case Study Essay Section of the Examination

Abdominal Procedures General Abdomen

1. ParacentesisGastrointestinal

2. Esophageal study3. Swallowing function study4. Upper GI study5. Small bowel study6. Enema with barium, air, or water soluble contrast7. Nasogastric/enteric or orogastric/enteric tube placementUrinary

8. Cystography, voiding cystography or voiding cystourethrography

Thoracic Procedures Pulmonary

9. Thoracentesis

Musculoskeletal and Endocrine Procedures Musculoskeletal

10. Arthrogram (shoulder or hip)

Neurological, Vascular, and Lymphatic Procedures Neurological

11. Lumbar puncture with or without contrast12. Cervical, thoracic, or lumbar myelography – imaging onlyVascular and Lymphatic

13. Peripherally inserted central catheter (PICC) placement

EXAMINATION CONTENT SPECIFICATIONS IMPLEMENTATION …

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