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Home Acute Hand and Wrist Trauma
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Wrist trauma, initial exam 3148779
Radiography wrist
<0.1 mSv
☢
Usually appropriate
US wrist
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI wrist without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI wrist without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT wrist with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan wrist
1-10 mSv
☢☢☢
Usually not appropriate
Hand trauma, initial exam 3148778
Radiography hand
<0.1 mSv
☢
Usually appropriate
US hand
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI hand without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI hand without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT hand with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan hand
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hand trauma, fracture suspected, neg or equivocal radiography 3148780
Radiography hand repeat in 10-14 days
<0.1 mSv
☢
Usually appropriate
MRI hand without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT hand without IV contrast
<0.1 mSv
☢
Usually appropriate
US hand
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI hand without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT hand with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan hand
1-10 mSv
☢☢☢
Usually not appropriate
Wrist trauma, fracture suspected, neg or equivocal radiography 3148782
Radiography wrist repeat in 10-14 days
<0.1 mSv
☢
Usually appropriate
MRI wrist without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT wrist without IV contrast
<0.1 mSv
☢
Usually appropriate
US wrist
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI wrist without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT wrist with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan wrist
1-10 mSv
☢☢☢
Usually not appropriate
Wrist trauma, fracture suspected, equivocal radiography 3148783
Radiography wrist repeat in 10-14 days
<0.1 mSv
☢
Usually appropriate
MRI wrist without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT wrist without IV contrast
<0.1 mSv
☢
Usually appropriate
US wrist
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI wrist without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT wrist with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan wrist
1-10 mSv
☢☢☢
Usually not appropriate
Hand trauma, fracture suspected, equivocal radiography 3148781
Radiography hand repeat in 10-14 days
<0.1 mSv
☢
Usually appropriate
MRI hand without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT hand without IV contrast
<0.1 mSv
☢
Usually appropriate
US hand
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI hand without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT hand with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan hand
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Wrist fracture, tendon or ligament trauma suspected, radiography done 3149335
US wrist
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MR arthrography wrist
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI wrist without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT arthrography wrist
<0.1 mSv
☢
Usually appropriate
MRI wrist without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT wrist with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan wrist
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Wrist trauma, subluxation on radiography 3149336
MR arthrography wrist
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI wrist without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT wrist without IV contrast bilateral
<0.1 mSv
☢
Usually appropriate
CT arthrography wrist
<0.1 mSv
☢
May be appropriate
US wrist
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI wrist without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT wrist with IV contrast bilateral
<0.1 mSv
☢
Usually not appropriate
CT wrist without and with IV contrast bilateral
<0.1 mSv
☢
Usually not appropriate
Bone scan wrist
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hand fracture, tendon or ligament trauma suspected, radiography done 3149337
US hand
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI hand without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI hand without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT hand with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan hand
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hand trauma, subluxation on radiography 3149338
US hand
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI hand without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI hand without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT hand with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan hand
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hand trauma, penetrating, foreign body suspected, neg radiography 3148784
US hand
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT hand without IV contrast
<0.1 mSv
☢
Usually appropriate
MRI hand without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI hand without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT hand with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT hand without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan hand
1-10 mSv
☢☢☢
Usually not appropriate
Wrist trauma, penetrating, foreign body suspected, neg radiography 3148785
US wrist
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT wrist without IV contrast
<0.1 mSv
☢
Usually appropriate
MRI wrist without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI wrist without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT wrist with IV contrast
<0.1 mSv
☢
Usually not appropriate
CT wrist without and with IV contrast
<0.1 mSv
☢
Usually not appropriate
Bone scan wrist
1-10 mSv
☢☢☢
Usually not appropriate
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