ACR AC Portal

Home Acutely Limping Child Up To Age 5

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Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Ped <=5yo, acute limp, non localized

3080849

Radiography tibia and fibula

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually appropriate

Radiography femur

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

May be appropriate

Radiography foot

<0.1 mSv
☢

<0.03 mSv [ped]
☢

May be appropriate
(Disagreement)

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US lower extremity

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

Radiography pelvis

0.1-1mSv
☢☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Radiography lumbar spine

1-10 mSv
☢☢☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI lower extremity without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI lower extremity without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT lower extremity with IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

CT lower extremity without and with IV contrast

1-10 mSv
☢☢☢

10-30 mSv [ped]
☢☢☢☢☢

Usually not appropriate

CT lower extremity without IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Ped <=5yo, acute limp, foot pain

3147516

Radiography foot

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually appropriate

US foot

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI foot without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI foot without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT foot with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT foot without and with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT foot without IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Ped <=5yo, acute limp, lower leg pain

3147514

Radiography tibia and fibula

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually appropriate

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US lower leg

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI lower leg without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI lower leg without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT lower leg with IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT lower leg without and with IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT lower leg without IV contrast

0.1-1mSv
☢☢

Usually not appropriate

Ped <=5yo, acute limp, hip pain

3147511

Radiography hip

1-10 mSv
☢☢☢

Usually appropriate

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI hip without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI hip without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT hip with IV contrast

1-10 mSv
☢☢☢

Usually not appropriate

CT hip without and with IV contrast

1-10 mSv
☢☢☢

Usually not appropriate

CT hip without IV contrast

1-10 mSv
☢☢☢

Usually not appropriate

Ped <=5yo, acute limp, knee pain

3147513

Radiography knee

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually appropriate

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US knee

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI knee without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI knee without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT knee with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT knee without and with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT knee without IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Ped <=5yo, acute limp, ankle pain

3147515

Radiography ankle

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually appropriate

US ankle

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI ankle without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI ankle without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT ankle with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT ankle without and with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT ankle without IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Ped <=5yo, acute limp, thigh pain

3147512

Radiography femur

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually appropriate

US hips

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US thigh

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI thigh without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI thigh without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT thigh with IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT thigh without IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT thigh without and with IV contrast

1-10 mSv
☢☢☢

Usually not appropriate

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Ped <=5yo, acute limp, non localized, infection suspected

3148180

MRI lower extremity without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI lower extremity without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

US hips

0 mSv
O

0 mSv [ped]
O

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

May be appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

May be appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

May be appropriate

US lower extremity

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

Radiography femur

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Radiography foot

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually not appropriate

Radiography tibia and fibula

<0.1 mSv
☢

<0.03 mSv [ped]
☢

Usually not appropriate

Radiography pelvis

0.1-1mSv
☢☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Radiography lumbar spine

1-10 mSv
☢☢☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT lower extremity with IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

CT lower extremity without and with IV contrast

1-10 mSv
☢☢☢

10-30 mSv [ped]
☢☢☢☢☢

Usually not appropriate

CT lower extremity without IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Ped <=5yo, acute limp, symptoms localized to hip, infection suspected

3148181

US hips

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI pelvis without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI pelvis without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

Radiography pelvis

0.1-1mSv
☢☢

0.03-0.3 mSv [ped]
☢☢

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

May be appropriate

Radiography lumbar spine

1-10 mSv
☢☢☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT pelvis with IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

CT pelvis without IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

CT pelvis without and with IV contrast

10-30 mSv
☢☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Ped <=5yo, acute limp, symptoms localized to thigh, infection suspected

3147517

MRI thigh without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI thigh without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

US thigh

0 mSv
O

0 mSv [ped]
O

May be appropriate

Radiography femur

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT thigh with IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT thigh without IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT thigh without and with IV contrast

1-10 mSv
☢☢☢

Usually not appropriate

Ped <=5yo, acute limp, symptoms localized to lower leg, infection suspected

3147519

MRI lower leg without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI lower leg without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

US lower leg

0 mSv
O

0 mSv [ped]
O

May be appropriate

Radiography tibia and fibula

<0.1 mSv
☢

<0.03 mSv [ped]
☢

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT lower leg with IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT lower leg without and with IV contrast

0.1-1mSv
☢☢

Usually not appropriate

CT lower leg without IV contrast

0.1-1mSv
☢☢

Usually not appropriate

Ped <=5yo, acute limp, symptoms localized to foot, infection suspected

3147521

MRI foot without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI foot without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

US foot

0 mSv
O

0 mSv [ped]
O

May be appropriate

Radiography foot

<0.1 mSv
☢

<0.03 mSv [ped]
☢

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT foot with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT foot without and with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT foot without IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Ped <=5yo, acute limp, symptoms localized to ankle, infection suspected

3147520

MRI ankle without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI ankle without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

US ankle

0 mSv
O

0 mSv [ped]
O

May be appropriate

Radiography ankle

<0.1 mSv
☢

<0.03 mSv [ped]
☢

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT ankle with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT ankle without and with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT ankle without IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

Ped <=5yo, acute limp, symptoms localized to knee, infection suspected

3147518

MRI knee without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

MRI knee without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually appropriate

US knee

0 mSv
O

0 mSv [ped]
O

May be appropriate

Radiography knee

<0.1 mSv
☢

<0.03 mSv [ped]
☢

May be appropriate

3-phase bone scan pelvis and lower extremity

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

MRI whole body without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRI whole body without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

CT knee with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT knee without and with IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate

CT knee without IV contrast

<0.1 mSv
☢

0.03-0.3 mSv [ped]
☢☢

Usually not appropriate