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Home Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Osteomyelitis suspected, foot, diabetic, initial imaging 3155930
Radiography foot
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		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
3-phase bone scan foot
1-10 mSv
☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Osteomyelitis suspected, foot, diabetic, radiography indeterminate for osteomyelitis, next imaging study 3199368
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
CT foot with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT foot without IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
3-phase bone scan foot
1-10 mSv
☢☢☢
May be appropriate
(Disagreement)
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Image-guided biopsy foot

Varies
Varies 		Usually not appropriate
CT foot without and with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
Osteomyelitis suspected, foot, diabetic, radiography negative for osteomyelitis, next imaging study 3199369
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
CT foot with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT foot without IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
3-phase bone scan foot
1-10 mSv
☢☢☢
May be appropriate
(Disagreement)
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Image-guided biopsy foot

Varies
Varies 		Usually not appropriate
CT foot without and with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Radiography positive for osteomyelitis of the foot, diabetic, next imaging study, pretreatment planning 3199371
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
Image-guided biopsy foot

Varies
Varies 		May be appropriate
CT foot with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT foot without IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
WBC scan foot
10-30 mSv
☢☢☢☢
May be appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT foot without and with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
3-phase bone scan foot
1-10 mSv
☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Osteomyelitis suspected, foot, diabetic, metal instrumentation in the foot, radiography negative for osteomyelitis, next imaging study 3199373
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
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT foot with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT foot without IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
May be appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
May be appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
May be appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Image-guided biopsy foot

Varies
Varies 		Usually not appropriate
CT foot without and with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
3-phase bone scan foot
1-10 mSv
☢☢☢
Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
Osteomyelitis suspected, foot, diabetic, metal instrumentation in the foot, radiography indeterminate for osteomyelitis, next imaging study 3199374
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
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT foot with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT foot without IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
May be appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
May be appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
May be appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Image-guided biopsy foot

Varies
Varies 		Usually not appropriate
CT foot without and with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
3-phase bone scan foot
1-10 mSv
☢☢☢
Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Radiography positive for osteomyelitis of the foot, diabetic, metal instrumentation in the foot, next imaging study, pre-treatment planning 3199376
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
Image-guided biopsy foot

Varies
Varies 		May be appropriate
CT foot with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
CT foot without IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
3-phase bone scan and WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
May be appropriate
3-phase bone scan and WBC scan foot
10-30 mSv
☢☢☢☢
May be appropriate
3-phase bone scan and WBC scan with SPECT or SPECT/CT foot
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
WBC scan and sulfur colloid scan foot
10-30 mSv
☢☢☢☢
May be appropriate
US foot
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT foot without and with IV contrast
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
3-phase bone scan foot
1-10 mSv
☢☢☢
Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
WBC scan foot
10-30 mSv
☢☢☢☢
Usually not appropriate
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