Career Options: Radiography or Sonography

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When it comes to good pay, job stability and fulfilling work, it’s hard to beat careers in healthcare. Diagnostic imaging careers are growing at a particularly fast pace within healthcare due to factors such as the aging U.S. population, more active lifestyles and advances in technology. Imaging fields such as radiography or sonography offer you a potential path to generous allied healthcare pay, fantastic job security and the ability to make a difference every day in patients’ lives.

Vivian Health explores the radiography or sonography fields, including the education and certification necessary to enter these expanding fields. We also review typical shifts for both professionals, compare sonography and radiography salaries and explore other differentiators to help you determine if you’ve found an ideal career path.

What Is a Radiographer?

Radiography gives doctors and other healthcare professionals detailed insights into the human body and has become a vital tool for modern diagnosis and treatment. A radiographer, also known as a radiologic technologist or rad tech, is an allied healthcare professional who creates medical images through radiography to help doctors diagnose and treat diseases or injuries. Radiography techniques rely on electromagnetic (EM) waves or radiation, distinguishing radiography from sonography, which uses sound waves for imaging.  

Key radiographer responsibilities include operating imaging equipment and positioning patients to capture clear and accurate images. They also adhere to safety protocols, such as minimizing exposure time and maximizing distance from radiation or EM sources, to ensure radiation and magnetic safety for patients, themselves and other healthcare workers. They collaborate with physicians to interpret images and provide technical insights while maintaining patient records and imaging equipment.

Radiography Technologies and Methods

• X-Ray: For imaging bones and detecting fractures or infections
• Computed Tomography (CT) For producing detailed cross-sectional images of body structures
• Magnetic Resonance Imaging (MRI): Uses magnetic fields and radio waves to visualize soft tissues, organs and structures
• Fluoroscopy: Live X-ray video for interventional procedures
• Nuclear Medicine: Uses radioactive chemicals to create 3D images of the body through Positron Emission Tomography and Single Photon Emission Computed Tomography 

Radiographer Work Environments and Patient Demographics

Radiographers work in diverse settings with a wide range of patient populations. They’re found in hospital emergency rooms (ERs), surgical suites and inpatient services. Radiographers also work in outpatient imaging centers, private practices and specialty departments like pediatrics, orthopedics or oncology. Patient demographics may include trauma patients in emergency settings, older adults with chronic conditions, pediatric patients needing specialized care and practically everyone in between.

What Is a Sonographer?

A sonographer, or ultrasound technologist, is an allied healthcare professional who uses high-frequency sound waves to create detailed images of internal body structures. These images assist in diagnosing and monitoring medical conditions. Because there’s no radiation or powerful magnets involved, ultrasound techniques typically have relaxed safety protocols compared to radiography. 

Sonographers operate ultrasound equipment, explain procedures to patients and ensure their comfort during imaging. They interpret images and provide preliminary findings to physicians. Additionally, they maintain patient records and calibrate the ultrasound equipment.

Sonographers may specialize in specific areas of care. For example:

• Abdominal Sonographers focus on organs such as the liver, kidneys and gallbladder.
• Cardiovascular Sonographers and echo-vascular techs evaluate the heart (echocardiography) and circulatory system for conditions like blockages or valve dysfunction.
• Obstetric and Gynecologic (OB-GYN) Sonographers monitor fetal development during pregnancy and help evaluate reproductive health.
• Musculoskeletal Sonographers examine muscles, tendons and joints for injuries or disorders.
• Neurosonographers specialize in imaging the brain and spinal cord.

Sonography Procedures and Equipment

• Transabdominal Ultrasound: A non-invasive scan of abdominal organs
• Transvaginal Ultrasound: Provides detailed images of pelvic organs
• Doppler Ultrasound: Measures blood flow and detects blockages
• 3D/4D Ultrasound: Advanced imaging for detailed fetal or organ visualization

Equipment includes ultrasound transducers, imaging consoles and advanced software for image analysis.

Sonographer Work Environments and Patient Demographics

Sonographers work in various healthcare settings and are well-known for their roles in OB-GYN clinics, where they focus on pregnancy, fertility assessments and gynecologic health. However, their expertise also extends to cardiology practices, where they perform evaluations of the heart and blood vessels, as well as orthopedic clinics, where they conduct musculoskeletal imaging to assess sports injuries, joint issues and chronic pain. Sonographers can be found in outpatient settings and private practices. They also play a crucial role in hospital teams, including emergency rooms and surgical suites, where they assist in diagnosing trauma and internal bleeding and provide guidance during surgeries.

Educational Pathways for Radiography and Sonography 

Radiographers and sonographers have similar education and training paths, as detailed below: 

• Radiography: Requires an associate or optional bachelor’s degree in radiologic technology, with 2–4 years of coursework including anatomy, patient care, radiologic physics and imaging principles. Certification from the American Registry of Radiologic Technologists (ARRT) or another credentialing authority is often required.

• Sonography: Requires an associate or optional bachelor’s degree in diagnostic medical sonography, with 2–4 years of coursework focusing on anatomy, medical terminology, ultrasound physics and hands-on training. Certification from the American Registry for Diagnostic Medical Sonography (ARDMS) or the AART is typically necessary.

Continuing Education, Specializations and Certification

The main pathways to advancement in medical imaging involve ongoing education, learning a specialty and demonstrating mastery of it through certification.

• Radiographers can pursue certifications that often lead to higher pay, including CT certification or MRI certification through ARRT. Some certifications lead to substantially higher salaries, including interventional radiography certification in vascular interventional radiography or cardiac interventional radiography. Among the highest-paid radiographers are those with one of two certifications in nuclear medicine—the Registered Technologist in Nuclear Medicine Technology from AART or the Certified Nuclear Medicine Technologist through the Nuclear Medicine Technology Certification Board.

• Sonographers may specialize in over a dozen areas that offer specialized certification, including breast sonography or vascular sonography.

Continuing education is mandatory for maintaining certifications and staying current with advancements in either field.

Day-to-Day Work Life: Radiographers vs. Sonographers

Though both are involved in diagnostic imaging, radiographers and sonographers may experience key differences in their day-to-day work.

Typical Day

• Radiographers may start their day by preparing imaging equipment, reviewing patient cases and performing scheduled or emergency imaging procedures. They often deal with trauma cases and collaborate closely with emergency teams.
• Sonographers often begin by reviewing patient histories and conducting scheduled ultrasound scans. They often work in quieter settings, focusing on detailed evaluations and patient interaction.

Patient Interactions and Collaboration

• Radiographers may interact briefly with patients, sometimes in high-pressure situations like emergencies or surgeries. Collaboration with radiologists, surgeons and ER doctors is common.
• Sonographers typically spend more time with patients, explaining procedures and ensuring comfort. They work closely with obstetricians, cardiologists, orthopedic surgeons and general physicians.

Shift Lengths and Emergency Calls

• Radiographers at hospitals or medical imaging centers often work 8-12 hour shifts, including nights and weekends. Emergency calls are common. Those in private practice, such as at an orthopedic clinic, may work more typical business hours.
• Sonographers typically work 8-hour shifts in outpatient settings and receive fewer emergency calls, though some specialties (e.g., obstetrics) may require on-call availability.

Salary Expectations and Job Growth Prospects for Radiographers or Sonographers

The question of who makes more, radiographers or sonographers, varies due to specialization and certification. While a generalist radiographer usually earns less than a sonographer, radiography specialists can earn more than the average of both occupations. 

Radiologic technologist salaries are usually quite good compared to the national average income. Based on Vivian Health’s salary data during the week of November 25, 2024, generalist radiographers averaged $40.69 per hour, translating to $1,628 per week or $84,635 annually when calculating the hourly rate by a typical 40-hour workweek. There are also opportunities for rad tech travel jobs, in which they earned an average of $2,316 per week during the same week, a substantial premium over a typical staff position. 

Various specialties within radiography can earn more. For example, as a subset of radiological technologists, MRI technologists receive higher pay due to their specialized training and the safety protocols of running an MRI machine. MRI techs were paid an average of $47.23 per hour during the same timeframe, about $1,889 weekly or $98,238 annually. A travel MRI tech also sees a pay premium, averaging $2,572 per week during the same period. Other radiography specialists who see higher pay than general radiographers include CT technologists, interventional radiographers and those working in nuclear medicine. 

Sonographers’ salaries are also rewarding. During the same week, they averaged $46.93 per hour, about $1,877 weekly or $97,614 annually. Like their colleagues in radiography, ultrasound techs can find travel positions that typically pay above standard. Average sonographer travel salaries during the same period were $2,458 per week.

Related: The Fastest Growing Allied Health Careers in 2025

If you’re considering a career in radiography or sonography, you’re in luck. Both careers are experiencing brisk job growth, although sonography has the edge. According to estimates by the Bureau of Labor Statistics, jobs for registered ultrasound technologists are expected to grow by 15% from 2023 to 2033. Meanwhile, radiology technologists are projected to experience 6% job growth over the same time frame. Both rates are faster than the average of 4% among all U.S. occupations combined.

Demand for both career types is linked to population size, so the states with the most sonographer and radiographer jobs are places with huge population centers like California, Texas, Illinois, New York and Florida. However, in certain states, demand has outpaced the area’s population. Within sonography, those states include Alaska, West Virginia, South Dakota, Michigan and Rhode Island, per BLS data. Within radiography, those states include West Virginia, Mississippi, South Dakota, Oklahoma and Kentucky. 

Physical Demands and Potential Job Stress

An assessment of radiographer and sonographer careers wouldn’t be complete without considering the challenges involved in each profession.

Radiographers work in physically demanding environments, spending long hours standing or walking and frequently lifting or positioning patients with limited mobility. Operating heavy equipment and wearing protective lead aprons add to the strain. The sometimes high-pressure nature of radiography, especially in emergencies, requires precise work, as errors can lead to repeat scans and increased radiation exposure.

Sonographers face physical strain from repetitive movements and prolonged positions, often using their hands and wrists to maneuver ultrasound transducers, which can lead to injuries like carpal tunnel syndrome. Stress stems from the need for accuracy, particularly during high-risk cases, compounded by the emotional challenges of working with a high patient volume.

Work-Life Balance Considerations

Work-life balance differs significantly between radiographers and sonographers based on work settings. Hospital radiographers often face 8-to-12-hour shifts with irregular hours, including nights, weekends and holidays. Emergency call duties can disrupt personal plans, though outpatient settings typically offer more predictable schedules.

Sonographers often benefit from structured schedules, especially in outpatient clinics with standard weekday hours. While hospital-based sonographers may occasionally handle on-call duties or weekend shifts, this is less common than in radiography. The field generally aligns better with traditional work hours, making it a more lifestyle-friendly option.

Embark on a Rewarding Career in Radiography or Sonography

Radiography and sonography offer rewarding healthcare careers with unique challenges. Radiographers handle physically demanding tasks and irregular schedules, while sonographers face repetitive physical strain but enjoy more predictable hours. Both fields require technical precision and patient care, offering good salaries and opportunities for specialization. Choosing between them depends on personal preferences for work environment and lifestyle goals, but both paths play a crucial role in healthcare.

If you’ve completed your training and you’re seeking your first diagnostic imaging role, let Vivian Health help. We share current listings for sonography jobs and radiography jobs posted by major health systems and recruiters. Download Vivian’s app to create your profile and begin your search.

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