ACR logo

ACR AC Portal

Home Cervical Pain or Cervical Radiculopathy
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine pain, increasing, no radiculopathy, no trauma, no red flags, initial imaging 3198703
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine pain, acute, no radiculopathy, no trauma, no red flags, initial imaging 3149324
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 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 pain, increasing, radiculopathy, no trauma, no red flags, initial imaging 3198704
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
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine pain, acute, radiculopathy, no trauma, no red flags, initial imaging 3149325
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
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 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 mechanical pain, increasing, no trauma, no red flags, prior cervical spine surgery, initial imaging 3149707
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine radiculopathy, increasing, no trauma, no red flags, prior cervical spine surgery, initial imaging 3198707
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine mechanical pain, acute, no trauma, no red flags, prior cervical spine surgery, initial imaging 3149708
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Cervical spine radiculopathy, acute, no trauma, no red flags, prior cervical spine surgery, initial imaging 3198706
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine radiculopathy, increasing, no trauma, infection, initial imaging 3198714
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine radiculopathy, increasing, no trauma, infection suspected, initial imaging 3198712
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine pain, increasing, no trauma, infection suspected, initial imaging 3149710
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine radiculopathy, acute, no trauma, infection suspected, initial imaging 3198711
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine pain, acute, no trauma, infection, initial imaging 3198709
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine radiculopathy, acute, no trauma, infection, initial imaging 3198713
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine pain, acute, no trauma, infection suspected, initial imaging 3149709
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine pain, increasing, no trauma, infection, initial imaging 3198710
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Gallium scan whole body
10-30 mSv
☢☢☢☢
Usually not appropriate
WBC scan whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cervical spine radiculopathy, increasing, no trauma, malignancy, initial imaging 3198716
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/MRI whole body
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
Fluoride PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine pain, acute, no trauma, malignancy, initial imaging 3149712
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/MRI whole body
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
Fluoride PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine pain, increasing, no trauma, malignancy, initial imaging 3149711
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/MRI whole body
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
Fluoride PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Cervical spine radiculopathy, acute, no trauma, malignancy, initial imaging 3198715
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/MRI whole body
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
Fluoride PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Headache, cervicogenic suspected, no neuro deficit, initial imaging 3149329
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 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 pain, chronic, no radiculopathy, no trauma, no red flags, initial imaging 3073955
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
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 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 pain, chronic, radiculopathy, no trauma, no red flags, initial imaging 3073960
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Radiography cervical spine
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		May be appropriate
(Disagreement)
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Discography cervical spine
0.1-1mSv
☢☢
Usually not appropriate
Radiography cervical spine flexion extension lateral views
0.1-1mSv
☢☢
Usually not appropriate
Radiographic myelography cervical spine
1-10 mSv
☢☢☢
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
Bone scan whole body with SPECT or SPECT/CT cervical spine
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
© 2025