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 opens in a new windowAppropriateness Criteria 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
  • Hemoptysis
  • 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
  • Dysphagia
  • Imaging of Mesenteric Ischemia
  • Jaundice
  • 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


  • Ataxia​​
  • Cerebrovascular Disease
  • Chronic Neck Pain
  • Dementia and Movement Disorders
  • Focal Neurologic Deficit
  • Head Trauma
  • Headache
  • Hearing Loss and Vertigo
  • Low Back Pain
  • Myelopathy
  • 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
  • Headache-Child
  • Hematuria-Child
  • Limping Child-Ages 0-5 years
  • Seizures-Child
  • Sinusitis-Child
  • 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
  • Hematuria
  • 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​​​