Protocols provide a baseline for audit opportunity as well as evidence for clinical governance, since the use of protocols ensure compliance with documented scope of professional practice. Objectives: We determined the existence and variations of radiographic protocols for radiographic examinations of axial and appendicular skeleton in X-ray departments within the Accra Metropolis and also to establish whether there were variations in the projections taken among the departments for these

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... tions. Methods: A questionnaire containing mostly open ended question, was given to the radiographers who were in-charge of the departments and those in charge of the various clinical rooms of the selected hospitals and polyclinics to complete. Codes were assigned each of the departments, the examinations and the sets of projections indicated for the examinations. The data gathered was analyzed using SPSS version 16 software and presented in tabular and graphical forms. Results: In all eight X-ray departments were studied. Majority (80%) of the respondents indicated having protocols. All respondents agreed to the technical fact that examination protocols must be written and documented and copies made available in all clinical rooms. Conversely, only 20% of the respondents representing 25% of the departments surveyed had examination protocols document. Conclusion: Radiographic examination protocols were lacking in most departments. There was lack of understanding among Radiographers in the departments without protocols about the concept of examination protocols and so confused it with radiographic technique. The absence of protocols led to variations in the projections taken among the departments. It also negated the radiographers' knowledge of radiographic techniques through the choice of wrong projections for some of the examinations, affecting the examination results and hence patient outcome.