This study aims to implement a visual radiograph examination decision-making support system to help physicians to issue a correct radiographic examination request form. In this research we are not only apply the theory of knowledge management to collect, classify, organize some existed medical radiographic images to build a visual medical radiation image database, but also establish a rule-based radiographic position decision support system. In the system architecture design, the system underlying operating system is Windows XP, and uses ASP as server-side implementation, and web interface design is Dreamweaver combine with Microsoft Access database system, the user can access the system easily by merely a Web browser, in this case, the system can provide a web-based feature thus overcome the barriers of time and space.