Ordering Criteria

ACR Appropriateness Criteria®

The ACR Appropriateness Criteria® (AC) can be used by referring providers to help make the appropriate imaging decision based on clinical indications. This is a list of common clinical indications. A full list can be found at acsearch.acr.org/list.


Acute Chest Pain – Suspected Aortic Dissection

Suspected Pulmonary Embolism

Acute Nonspecific Chest Pain – Low Probability of Coronary Artery Disease

Asymptomatic Patient at Rick for Coronary Artery Disease

Chest Pain Suggestive of Acute Coronary Artery Disease

Chronic Chest Pain – Low to Intermediate Probability of Coronary Artery Disease

Known or Suspected Congenital Heart Disease in the Adult

Nonischemic Myocardical Disease with Clinical Manifestations


Acute Respiratory Illness in Immuno​​​competent Patients​

Acute Respiratory Illness in Immunocompromised Patients

Blunt Chest Traum​​a​

Chronic Dyspnea-Suspected Pulmonary Origin


Imaging of Possible Tuberculosis

Intensive Care Unit Patients

Occupational Lung Diseases

Pulmonary Hypertension

Radiographically Detected Solitary Pulmonary Nodule

Rib Fractures

​​Routine Chest Radiography​


Acute (Nonlocalized) Abdominal Pain and Fever or Suspected Abdominal Abscess​​

Acute Pancreatitis

Blunt Abdominal Trauma

Crohn Disease


Imaging of Mesenteric Ischemia


Left Lower Quadrant Pain-Suspected Diverticulitis

Liver Lesion-Initial Characterization

Nonvariceal Upper Gastrointestinal Bleeding

Palpable Abdominal Mass

Right Lower Quadrant Pain-Suspected Appendicitis​

Right Upper Quadrant Pain

Suspected Small Bowel Obstruction​


Acute Hand and Wrist Trauma

Acute Hip Pain-Suspected Fracture

Acute Trauma to the Ankle

Acute Trauma to the Foot

Acute Trauma to the Knee

Nontraumatic Knee Pain

Stress (Fatigue-Insufficiency) Fracture Including Sacrum Excluding Other Vertebrae

Suspected Spine Trauma



Cerebrovascular Disease

Chronic Neck Pain

Dementia and Movement Disorders

Focal Neurologic Deficit

Head Trauma


Hearing Loss and Vertigo

Low Back Pain


Neck Mass-Adenopathy

Orbits Vision and Visual Loss

Seizures and Epilepsy

Sinonasal Disease

Suspected Spine Trauma​


Back Pain-Child

Developmental Dysplasia of Hip-Child

Fever Without Source or Unknown Origin-Child

Head Trauma-Child



Limping Child-Ages 0-5 years



Suspected Physical Abuse-Child

Urinary Tract Infection-Child

Vomiting in Infants Up to 3 Months of Age​


Acute Onset Flank Pain-Suspicion of Stone Disease (Urolithiasis)​

Acute Onset of Scrotal Pain-Without Trauma Without Antecedent Mass

Acute Pyelonephritis


Incidentally Discovered Adrenal Mass

Indeterminate Renal Mass

Renal Failure

Renal Trauma

Suspected Lower Urinary Tract Trauma​


Blunt Abdominal Trauma

Blunt Chest Trauma-Suspected Aortic Injury

Nonvariceal Upper Gastrointestinal Bleeding

Pulsatile Abdominal Mass Suspected AAA

Sudden Onset Cold Painful Leg

Suspected Lower Extremity Deep Vein Thrombosis

Upper Extremity Swelling​


Abnormal Vaginal Bleeding

Acute Pelvic Pain in the Reproductive Age Group

First Trimester Bleeding

Second and Third Trimester Bleeding​​​