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Home Acute Spinal Trauma
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine trauma, acute, blunt, imaging not indicated by CCR or Nexus, low-risk criteria, initial imaging 3198843
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine trauma, acute, blunt, imaging indicated by CCR or NEXUS, initial imaging 3149687
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, paresthesia in extremities, initial imaging 3198845
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, falls from ≥3 feet or 5 stairs, initial imaging 3198847
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, focal neuro deficit, initial imaging 3149685
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, midline spinal tenderness, initial imaging 3149684
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, age>65 years, initial imaging 3198844
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, motor vehicle crash with high speed, rollover, or ejection, initial imaging 3198849
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, altered level of consciousness, initial imaging 3149682
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, motorized recreational vehicle accident, initial imaging 3198851
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, intoxication, initial imaging 3149686
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, dangerous mechanism, initial imaging 3198846
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, axial load to head, initial imaging 3198848
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, distracting injury, initial imaging 3149683
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, bicycle collision, initial imaging 3198850
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine trauma, acute, blunt, no unstable injury initially, collar for neck pain, no new neuro symptoms, follow-up imaging 3149319
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine trauma, acute, blunt, arterial injury suspected, with or without positive cervical spine CT, next imaging study 3149317
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Thoracic spine blunt trauma, spinal cord injury suspected, with or without trauma on CT, next imaging study 3198861
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA thoracic spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, ligamentous injury, with or without trauma on CT, next imaging study 3198854
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervical spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA cervical spine with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, spinal cord injury, with or without trauma on CT, next imaging study 3198868
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA lumbar spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, spinal cord injury, with or without trauma on CT, next imaging study 3198856
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervical spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA cervical spine with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, nerve root injury, with or without trauma on CT, next imaging study 3198858
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervical spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA cervical spine with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, nerve root injury suspected, with or without trauma on CT, next imaging study 3198863
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA thoracic spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, ligamentous injury suspected, with or without traumatic injury on CT, next imaging study 3198865
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA lumbar spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, ligamentous injury suspected, with or without trauma on CT, next imaging study 3198853
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervical spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA cervical spine with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, nerve root injury, with or without trauma on CT, next imaging study 3149314
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA lumbar spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine trauma, acute, blunt, spinal cord injury suspected, with or without trauma on CT, next imaging study 3198855
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervical spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA cervical spine with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, nerve root injury suspected, with or without trauma on CT, next imaging study 3198869
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA lumbar spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine blunt trauma, ligamentous injury, with or without trauma on CT, next imaging study 3198860
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA thoracic spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, spinal cord injury, with or without trauma on CT, next imaging study 3198862
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA thoracic spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, spinal cord injury suspected, with or without traumatic injury on CT, next imaging study 3198867
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA lumbar spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, ligamentous injury, with or without traumatic injury on CT, next imaging study 3198866
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA lumbar spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine blunt trauma, nerve root injury suspected, with or without trauma on CT, next imaging study 3198857
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography cervical spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA cervical spine with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, ligamentous injury suspected, with or without trauma on CT, next imaging study 3198859
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA thoracic spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, nerve root injury, with or without trauma on CT, next imaging study 3198864
MRI complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
Arteriography complete spine
30-100 mSv
☢☢☢☢☢
Usually not appropriate
MRA complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA complete spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI complete spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA complete spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CTA thoracic spine with IV contrast
10-30 mSv
☢☢☢☢
Usually not appropriate
CT myelography complete spine
30-100 mSv
☢☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Thoracic spine trauma, acute, blunt, high-energy injury mechanisms, initial imaging 3198873
CT thoracic spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT thoracic spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CT thoracic spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, high-risk, initial imaging 3111290
CT thoracic spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT thoracic spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CT thoracic spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, high-energy injury mechanisms, initial imaging 3198878
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Lumbar spine trauma, acute, blunt, >60yo, mechanism consistent with thoracolumbar spine injury, initial imaging 3198880
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Lumbar spine trauma, acute, blunt, midline thoracolumbar tenderness, initial imaging 3198877
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Thoracic spine trauma, acute, blunt, unexaminable, initial imaging 3198870
CT thoracic spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT thoracic spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CT thoracic spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, >60yo, mechanism consistent with thoracolumbar spine injury, initial imaging 3198875
CT thoracic spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT thoracic spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CT thoracic spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Thoracic spine trauma, acute, blunt, >60yo, complaints consistent with thoracolumbar spine injury, initial imaging 3198874
CT thoracic spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT thoracic spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CT thoracic spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, >60yo, complaints consistent with thoracolumbar spine injury, initial imaging 3198879
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Thoracic spine trauma, acute, blunt, midline thoracolumbar tenderness, initial imaging 3198872
CT thoracic spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography thoracic spine
1-10 mSv
☢☢☢
Usually not appropriate
MRI thoracic spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI thoracic spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT thoracic spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography thoracic spine
10-30 mSv
☢☢☢☢
Usually not appropriate
CT thoracic spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Lumbar spine trauma, acute, blunt, unexaminable, initial imaging 3198871
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Lumbar spine trauma, acute, blunt, high-risk, initial imaging 3198876
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Radiography lumbar spine
1-10 mSv
☢☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine trauma, acute, blunt, obtunded, no trauma on cervical spine CT without IV contrast, next imaging study 3149316
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
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