Variant 1.

Fever, elevated white blood cell count, positive Murphy sign

Radiologic Procedure	Rating	Comments	Relative Radiation Level
Ultrasound abdomen	9		○
MRI abdomen without and with contrast	6	See statement regarding contrast in text under “Anticipated Exceptions.”	○
Cholescintigraphy	6	Based on ultrasound findings, this generally should follow ultrasound of the right upper quadrant.	☢ ☢
CT abdomen with contrast	6		☢ ☢ ☢
MRI abdomen without contrast	4		○
CT abdomen without contrast	4		☢ ☢ ☢
CT abdomen without and with contrast	3		☢ ☢ ☢ ☢

Note: Rating scale: 1, 2, and 3 = usually not appropriate; 4, 5, and 6 = may be appropriate; 7, 8, and 9 = usually appropriate.