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100+ Free DACBR Practice Questions

Pass your Diplomate, American Chiropractic Board of Radiology exam on the first try — instant access, no signup required.

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Question 1
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On a cervical AP open-mouth (APOM) view, the C1 lateral mass overhangs the C2 superior articular surface bilaterally by 3 mm each (combined overhang 6 mm). This finding most strongly suggests:

A
B
C
D
to track
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Key Facts: DACBR Exam

DACBR is the post-doctoral specialty diplomate for chiropractic radiology. Eligibility requires a Doctor of Chiropractic degree, active license, and completion (or final-year enrollment) of a 3-4 year full-time chiropractic radiology residency. Candidates have 4 consecutive calendar years to complete both Part 1 and Part 2, with a maximum of 3 attempts per part. Examination content spans positioning/technique, normal anatomy, ABCS pathology search, arthritides, trauma classification, tumors, metabolic bone disease, infection, congenital anomalies, MRI/CT/ultrasound, radiation safety, and ACR Appropriateness Criteria.

Sample DACBR Practice Questions

Try these sample questions to test your DACBR exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A lateral cervical spine radiograph in a 35-year-old shows complete loss of the C5-C6 disc space height, end-plate sclerosis, anterior osteophyte bridging, and absent facet erosions. ABCS analysis most likely supports which diagnosis?
A.Rheumatoid arthritis
B.Osteoarthritis (degenerative disc disease)
C.Ankylosing spondylitis
D.Psoriatic arthritis
Explanation: Disc-space narrowing with end-plate sclerosis and anterior osteophyte bridging is classic spondylosis/OA. RA spares the disc and attacks the synovial atlanto-axial articulation. AS produces shiny corners and thin syndesmophytes that bridge vertebrae without disc-space loss until late. Psoriatic arthritis usually targets DIP joints and SI joints, with bulky paravertebral ossification rather than disc-centered changes.
2A pediatric distal radius fracture shows a fracture line that traverses the physis and exits through the metaphysis only, without epiphyseal involvement. Per the Salter-Harris classification, this is which type?
A.Type I
B.Type II
C.Type III
D.Type IV
Explanation: Salter-Harris II fractures travel through the physis and exit through the metaphysis (Thurston-Holland fragment). Type II is by far the most common Salter-Harris injury, accounting for roughly 75% of pediatric physeal fractures.
3On a knee MRI, a lesion in the distal femur is dark (low signal) on T1 and bright (high signal) on T2 with STIR hyperintensity. The most accurate single-sequence inference is:
A.Hemorrhage in the subacute phase
B.Fluid or edema-equivalent signal
C.Fat-containing lesion
D.Calcified matrix
Explanation: Low T1 + high T2 + high STIR is the classic 'fluid-bright/edema' signature: STIR suppresses fat, so any persistent bright signal on STIR represents free water (edema, cyst, effusion, or fluid). Hemorrhage signal changes over time (e.g., subacute met-Hb is T1 bright), fat is T1 bright and STIR dark, and calcified matrix is low signal on all sequences.
4A 14-year-old presents with night pain in the proximal tibia relieved by NSAIDs. Radiograph shows a 1-cm radiolucent nidus surrounded by dense cortical reactive sclerosis in the diaphysis. The most likely diagnosis is:
A.Osteoid osteoma
B.Brodie abscess
C.Stress fracture
D.Non-ossifying fibroma
Explanation: Night pain dramatically relieved by NSAIDs and a small (<2 cm) radiolucent nidus with surrounding reactive sclerosis in a teenager's long-bone diaphysis is the textbook description of osteoid osteoma. Confirmation is typically by CT, and CT-guided radiofrequency ablation is curative.
5ALARA principles in chiropractic radiography are best served by which of the following technique changes when image quality is otherwise acceptable?
A.Increasing mAs and decreasing kVp
B.Adding a higher-ratio grid in a small patient
C.Increasing kVp and reducing mAs proportionally
D.Using a smaller image receptor to crop anatomy
Explanation: Raising kVp and reducing mAs proportionally maintains image density while lowering patient dose, because mAs scales linearly with dose while higher kVp gives more penetrating photons with less absorbed dose. Adding grids and increasing mAs raise dose; cropping with a smaller receptor risks missed pathology and repeat exposures.
6An anteroposterior pelvis radiograph in a 28-year-old with chronic low back pain shows bilateral, symmetric blurring and erosion of the SI joint cortex with adjacent sclerosis. The next vertebral-body finding most consistent with the unifying diagnosis would be:
A.Marginal osteophytes at L4-L5
B.Squared vertebral bodies with shiny corners
C.Endplate erosions with disc-space preservation
D.Bulky asymmetric paravertebral ossification
Explanation: Bilateral symmetric sacroiliitis is the hallmark of ankylosing spondylitis. In AS, Romanus lesions cause inflammatory erosion of the vertebral corners followed by reactive sclerosis ('shiny corners') and squaring as the normal anterior concavity is lost. Marginal syndesmophytes then bridge the bodies vertically.
7A lateral knee radiograph in a 45-year-old skier shows a tibial plateau fracture with pure cleavage of the lateral plateau and a vertical split, no depression. Per Schatzker classification, this is type:
A.Schatzker I
B.Schatzker II
C.Schatzker IV
D.Schatzker VI
Explanation: Schatzker I is a pure lateral plateau cleavage (wedge) fracture without depression, typical in younger patients with strong subchondral bone. Schatzker II adds depression to a lateral split. Schatzker IV involves the medial plateau (often high-energy), and Schatzker VI is bicondylar with metaphyseal-diaphyseal dissociation.
8Codman triangle, sunburst spiculation, and aggressive periosteal reaction in the distal femur of a 16-year-old most strongly suggest:
A.Osteosarcoma
B.Ewing sarcoma
C.Aneurysmal bone cyst
D.Fibrous dysplasia
Explanation: Conventional osteosarcoma in adolescents classically presents with aggressive periosteal reaction including Codman triangle and sunburst spiculation in the metaphysis of long bones (distal femur, proximal tibia, proximal humerus). Ewing sarcoma also has aggressive periosteal reaction but more commonly shows lamellated ('onion-skin') reaction in the diaphysis.
9A 72-year-old woman has a DEXA hip T-score of -2.7. By WHO criteria, this places her in which category?
A.Normal bone density
B.Osteopenia
C.Osteoporosis
D.Severe osteoporosis
Explanation: WHO DEXA categories: T >= -1.0 normal; -1.0 to -2.5 osteopenia; <= -2.5 osteoporosis; <= -2.5 with a fragility fracture is severe osteoporosis. A T-score of -2.7 without a fracture meets osteoporosis criteria.
10A chest radiograph incidental finding shows a smoothly marginated 5-mm pulmonary nodule in the right upper lobe of a 35-year-old non-smoker. The most appropriate next step per Fleischner Society 2017 guidelines is:
A.Immediate biopsy
B.PET-CT within 1 week
C.No routine follow-up (optional 12-month CT)
D.CT-guided ablation
Explanation: Fleischner 2017 guidelines for solid nodules <6 mm in low-risk patients recommend no routine follow-up, with optional CT at 12 months left to clinical judgment. Aggressive workup of sub-6-mm nodules in low-risk patients adds cost and radiation without proven benefit.

About the DACBR Exam

The DACBR (Diplomate of the American Chiropractic Board of Radiology) certifies chiropractic radiologists who have completed a full-time 3-4 year postgraduate radiology residency. The credential is recognized across chiropractic education and clinical referral networks for image interpretation, teleradiology, and faculty appointments. Certification is granted only after passing both Part 1 and Part 2 of the ACBR examination.

Questions

100 scored questions

Time Limit

Two-part written examination (Part 1 and Part 2) administered annually

Passing Score

Criterion-referenced (ACBR subject-matter expert standard)

Exam Fee

Fees set annually by ACBR; contact the Board Exam Coordinator (American Chiropractic Board of Radiology (ACBR))

DACBR Exam Content Outline

Core

Radiographic Positioning and Technique

kVp/mAs selection, grid ratio, SID, image-receptor size, central ray, ALARA, and quality control to minimize repeats

Core

Normal Radiographic Anatomy and Variants

Spine, pelvis, chest, abdomen, skull, extremities, and pseudo-lesion variants commonly mistaken for pathology

Core

ABCS Search Pattern

Alignment, Bone density, Cartilage spaces, Soft tissues - systematic interpretation across MSK and chest studies

Core

Arthritides

RA, OA, AS, psoriatic, reactive, JIA, gout, CPPD, and seronegative spondyloarthropathy distribution patterns

Core

Trauma and Fracture Classification

Salter-Harris, Schatzker, Lauge-Hansen, Garden, Weber, Denis 3-column, AO, plus stress and avulsion injuries

Core

Tumors and Tumor-like Lesions

Aggressive vs non-aggressive imaging features, Codman triangle, sunburst, lytic vs blastic patterns, age/site predilections

Core

Metabolic and Endocrine Bone Disease

Osteoporosis, Paget, rickets/osteomalacia, hyperparathyroidism, renal osteodystrophy, DEXA T- and Z-score interpretation

Core

Infection

Osteomyelitis, septic arthritis, discitis, TB spine - imaging features and ACR Appropriateness modality choice

Core

Congenital and Developmental Anomalies

Spinal segmentation anomalies, tarsal coalitions, skeletal dysplasias, scoliosis screening, pediatric variants

Core

MRI, CT, and Musculoskeletal Ultrasound

T1/T2/STIR/FLAIR signal characteristics, CT windowing, MSK US basics, and modality selection per clinical question

Core

Chest, Abdomen, and Incidentals

Pulmonary nodules, mediastinal masses, aortic findings, abdominal calcifications, red-flag incidentals requiring referral

Core

Radiation Safety and Contrast

ALARA, time/distance/shielding, dose limits, iodinated and gadolinium contrast safety, NSF risk

How to Pass the DACBR Exam

What You Need to Know

  • Passing score: Criterion-referenced (ACBR subject-matter expert standard)
  • Exam length: 100 questions
  • Time limit: Two-part written examination (Part 1 and Part 2) administered annually
  • Exam fee: Fees set annually by ACBR; contact the Board Exam Coordinator

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

DACBR Study Tips from Top Performers

1Build a daily ABCS search pattern - Alignment, Bone density, Cartilage spaces, Soft tissues - and apply it to every film you read in residency
2Memorize age-and-location predilections for the common bone tumors: osteoid osteoma, GCT, osteosarcoma, Ewing, chondrosarcoma, simple bone cyst, ABC, NOF
3Drill arthritis distribution patterns: RA (MCP/PIP, symmetric, erosive), OA (DIP/PIP, asymmetric, osteophytes), psoriatic (DIP, pencil-in-cup), AS (SI joint, syndesmophytes)
4Master Salter-Harris, Schatzker, Lauge-Hansen, Garden, Weber, and Denis 3-column classifications - they are high-yield exam content
5Practice T1 vs T2 vs STIR signal interpretation until you can call signal characteristics in under 5 seconds per sequence
6Use the ACR Appropriateness Criteria to justify modality choices in case-based questions
7Review the chiropractic radiology textbooks of record (Yochum & Rowe; Marchiori; Brant & Helms) systematically across the residency
8Score practice tests honestly and re-read the wrong-answer explanations until you can teach the case to a junior resident

Frequently Asked Questions

What is the DACBR exam format?

DACBR is a two-part written examination (Part 1 and Part 2) administered annually by the American Chiropractic Board of Radiology. Item counts are set per administration and include scored questions plus unscored pilot items used for future test development.

What are the eligibility requirements?

Candidates must hold a Doctor of Chiropractic degree, be licensed (or eligible for licensure) to practice as a chiropractor, and be enrolled in the final year or have completed a 3- or 4-year full-time postgraduate chiropractic radiology residency.

How many attempts are allowed?

Candidates have four consecutive calendar years from initial eligibility to complete both Part 1 and Part 2, with a maximum of three attempts per part within that window.

Who administers the DACBR exam?

The American Chiropractic Board of Radiology (ACBR), an independent specialty board. The companion academic society is the American Chiropractic College of Radiology (ACCR).

How is the DACBR exam scored?

Scoring is criterion-referenced. ACBR subject-matter experts establish the minimally competent candidate standard for each examination form; the published pass/fail decision is based on that standard, not a fixed percent score.

What imaging modalities are tested?

Plain-film radiography is the largest body of content, but candidates are also tested on MRI (T1/T2/STIR/FLAIR signal characteristics), CT (windowing and 3D reconstruction), musculoskeletal ultrasound basics, and ACR Appropriateness Criteria for modality selection.

Does the DACBR cover non-musculoskeletal imaging?

Yes. While MSK is the dominant body of content, candidates must also recognize relevant chest, abdomen, and head/neck findings, including incidental findings that warrant referral, and understand basic radiation safety and contrast administration principles.