Radiographic Pathology

Course Description

RTE2782C – Radiographic Pathology is a second-year course in Florida's Radiography A.S. curriculum covering the disease processes a radiographer encounters and how they appear on medical images. Credit value varies by institution, commonly 2 or 3 credits.

The course occupies a carefully defined professional space. A radiographer does not diagnose — interpretation is the radiologist's responsibility, and offering a diagnosis to a patient is outside scope. But a radiographer who recognizes pathology on an image produces better work in three specific ways: they adjust technique appropriately, they recognize findings requiring immediate notification, and they understand why a particular examination was ordered.

Technique adjustment is the most concrete application. Additive pathologies — pneumonia, pleural effusion, ascites, Paget disease — increase tissue density and may require more exposure. Destructive pathologies — emphysema, osteoporosis, bowel obstruction, atrophy — decrease it and may require less. A technologist who applies standard technique to a patient with severe emphysema produces an overexposed, non-diagnostic image and a repeat exposure.

Content is organized by body system: respiratory, skeletal, gastrointestinal, genitourinary, cardiovascular, nervous, hepatobiliary, endocrine, and reproductive. For each, students cover common pathologies, their radiographic appearance, the imaging modality best suited to demonstrate them, and the technical implications.

Trauma receives specific attention — fracture classification and description, dislocations, and the modified positioning trauma requires. Modality selection is covered throughout: why CT for acute head injury, MRI for soft tissue and spinal cord, ultrasound for gallbladder, and nuclear medicine for bone metastases.

Offered at approximately 17 Florida institutions with JRCERT-accredited radiography programs.

Learning Outcomes

Required Outcomes

• Define pathology terminology and describe general disease processes and classifications.
• Distinguish additive from destructive pathologies and predict their effect on radiographic density.
• Adjust exposure technique appropriately for additive and destructive conditions.
• Recognize common respiratory pathologies on radiographic images.
• Recognize common skeletal pathologies including fractures, arthritis, and bone lesions.
• Classify and describe fractures using accepted terminology.
• Recognize common gastrointestinal and hepatobiliary pathologies.
• Recognize common genitourinary pathologies.
• Recognize common cardiovascular and nervous system pathologies.
• Identify findings requiring immediate notification of the radiologist or ordering physician.
• Describe the imaging modality best suited to demonstrate a given pathology.
• Relate the clinical history and indication to the examination ordered.
• Modify positioning appropriately for trauma and for patient condition.
• Describe the radiographer's scope of practice regarding image interpretation and communication with patients.

Optional Outcomes

• Describe cross-sectional appearance of common pathologies in CT and MRI.
• Describe pediatric pathology and its distinctive presentations.
• Describe pathology of aging and its imaging implications.
• Describe oncologic imaging and staging.
• Describe interventional procedures and their indications.
• Analyze case studies correlating history, images, and diagnosis.

Major Topics

Required Topics

• Introduction to pathology — terminology, disease classification, and general processes including inflammation and neoplasia.
• Additive and destructive pathology — density effects and technique compensation.
• Respiratory system — pneumonia, COPD and emphysema, pneumothorax, pleural effusion, atelectasis, tuberculosis, and neoplasms.
• Skeletal system — fracture types and classification, dislocations, osteoarthritis, rheumatoid arthritis, osteoporosis, osteomyelitis, Paget disease, and bone tumors.
• Fracture description — location, type, displacement, angulation, and accepted terminology.
• Gastrointestinal system — obstruction, perforation and free air, ulcers, diverticular disease, and neoplasms.
• Hepatobiliary system — cholelithiasis, cirrhosis, and hepatic lesions.
• Genitourinary system — calculi, obstruction, infection, and renal masses.
• Cardiovascular system — cardiomegaly, congestive heart failure, aneurysm, and vascular disease.
• Nervous system — hemorrhage, stroke, trauma, and space-occupying lesions.
• Trauma imaging — positioning modification, portable technique, and the trauma series.
• Modality selection — radiography, CT, MRI, ultrasound, and nuclear medicine matched to pathology.
• Critical findings — recognizing and escalating findings requiring immediate attention.
• Scope of practice — the boundary between recognition and diagnosis.

Optional Topics

• Cross-sectional pathology in CT and MRI.
• Pediatric pathology.
• Pathology of aging.
• Oncologic imaging and staging.
• Interventional procedures.
• Case study correlation.

Resources & Tools

• Radiographic Pathology for Technologists (Kowalczyk), Elsevier — the standard text for this course.
• Introduction to Radiologic Sciences and Patient Care (Adler & Carlton) — supporting reference.
• Merrill's Atlas of Radiographic Positioning — for the trauma positioning content.
• Teaching file image libraries — programs typically maintain case collections; Radiopaedia and MedPix are freely available and widely used.
• PACS access — reviewing real images during clinical rotation is the most effective learning.
• ARRT content specifications — pathology appears within Procedures and Image Analysis domains.
• ASRT Radiography Curriculum — the framework shaping course content.

Career Pathways

• Radiologic Technologist (SOC 29-2034) — pathology recognition improves image quality and reduces repeats daily.
• Computed Tomography Technologist — where pathology recognition matters most, since CT protocols often adjust to findings.
• MRI Technologist (SOC 29-2035) and Interventional Radiography.
• Trauma and Emergency Radiography — a demanding specialization this course supports directly.
• PACS Administrator and Applications Specialist.
• Radiologist Assistant (RA) — an advanced practice role requiring a master's degree and ARRT certification.
• Program Faculty — requiring additional education.

Special Information

Credit variation — check locally

Santa Fe College lists RTE2782 at 2 credits; Florida State College at Jacksonville lists it at 3 credits with prerequisites of BSC2085C and BSC2086C. The course also appears as both RTE2782 and RTE2782C. Under SCNS these are equivalent at the same level, but students transferring between Florida radiography programs should confirm the credit value, and program directors should compare contact hours.

Prerequisites

Admission to the radiography program is universal. Course-level prerequisites are anatomy and physiology — FSCJ requires BSC2085C and BSC2086C — and the preceding radiographic procedures sequence, since recognizing abnormal anatomy requires knowing normal anatomy well. Verify locally.

The scope boundary is the professional core of this course

This deserves emphasis because students get it wrong in both directions. A radiographer who says nothing when an image shows a pneumothorax has failed the patient; a radiographer who tells the patient they have pneumonia has practiced medicine without a license. The correct behavior is to recognize, and communicate through the correct channel — alert the radiologist or ordering physician for findings needing urgent attention, and refer all patient questions about results to the physician. Instructors teach the distinction explicitly, and it appears on the ARRT examination.

Technique compensation is the highest-frequency application

Of everything in this course, adjusting exposure for additive and destructive pathology is what a technologist uses most. It reduces repeat exposures — which means less patient dose and less wasted time — and it is a visible marker of competence. A new technologist who consistently produces diagnostic images on difficult patients is noticed quickly.

Position in the curriculum

This is a second-year course, normally taken after anatomy, positioning, and exposure coursework, and often alongside advanced clinical rotation where students see the pathology under discussion in real images. Its content is represented on the ARRT examination within the Procedures and Image Analysis domains, and it is reviewed again in RTE2061 Radiographic Seminar.

Learn from images, not only from text

Practical advice instructors consistently give: pathology recognition is pattern recognition, and pattern recognition comes from volume. Students who review teaching files and study real images during clinical rotation develop the skill considerably faster than those who study descriptions in a textbook. Free resources such as Radiopaedia make this accessible outside clinical hours.