We construct a medical X-ray direct digital radiography (DDR) system based on a CCD (charge-coupled devices) camera. For the original images captured from X-ray exposure, computer first executes image flat-field correction and image gamma correction, and then carries out image contrast enhancement. A hybrid image contrast enhancement algorithm which is based on sharp frequency localization-contourlet transform (SFL-CT) and contrast limited adaptive histogram equalization (CLAHE), is proposed and verified by the clinical DDR images. Experimental results show that, for the medical X-ray DDR images, the proposed comprehensive preprocessing algorithm can not only greatly enhance the contrast and detail information, but also improve the resolution capability of DDR system.