iDuke Signature Care, Durham, North Carolina; American College of Physicians. jUniversity of Alabama at Birmingham, Birmingham, Alabama, Primary care physician. kSchmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; American College of Emergency Physicians. lOregon Health & Science University, Portland, Oregon; American College of Surgeons. mNorthShore University HealthSystem, Evanston, Illinois. nNew York University Langone Medical Center, New York, New York. oUniversity of Cincinnati Medical Center, Cincinnati, Ohio. pMcMaster University, Hamilton, Ontario, Canada; Commission on Nuclear Medicine and Molecular Imaging. qSpecialty Chair, Virginia Commonwealth University Medical Center, Richmond, Virginia. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Right Upper Quadrant Pain Discussion of Procedures by Variant Variant 1: Right upper quadrant pain. Unknown etiology. Initial Imaging. In this clinical scenario, the patient presents with right upper quadrant pain and may have associated signs and symptoms. Although biliary disease is in the differential, it is not necessarily the leading consideration from the clinical presentation, and many other etiologies remain possible diagnostic considerations. Imaging methods for initial evaluation in patients in this clinical variant should be able to detect or exclude biliary disease and these other alternate diagnoses. CT Abdomen CT scanners are the workhorse modality for the assessment of nonspecific abdominal pain. CT also has the advantage of assessment of complications related to AC, as well as diagnosis of extrabiliary sources of right upper quadrant pain.
Right Upper Quadrant Pain. iDuke Signature Care, Durham, North Carolina; American College of Physicians. jUniversity of Alabama at Birmingham, Birmingham, Alabama, Primary care physician. kSchmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; American College of Emergency Physicians. lOregon Health & Science University, Portland, Oregon; American College of Surgeons. mNorthShore University HealthSystem, Evanston, Illinois. nNew York University Langone Medical Center, New York, New York. oUniversity of Cincinnati Medical Center, Cincinnati, Ohio. pMcMaster University, Hamilton, Ontario, Canada; Commission on Nuclear Medicine and Molecular Imaging. qSpecialty Chair, Virginia Commonwealth University Medical Center, Richmond, Virginia. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Right Upper Quadrant Pain Discussion of Procedures by Variant Variant 1: Right upper quadrant pain. Unknown etiology. Initial Imaging. In this clinical scenario, the patient presents with right upper quadrant pain and may have associated signs and symptoms. Although biliary disease is in the differential, it is not necessarily the leading consideration from the clinical presentation, and many other etiologies remain possible diagnostic considerations. Imaging methods for initial evaluation in patients in this clinical variant should be able to detect or exclude biliary disease and these other alternate diagnoses. CT Abdomen CT scanners are the workhorse modality for the assessment of nonspecific abdominal pain. CT also has the advantage of assessment of complications related to AC, as well as diagnosis of extrabiliary sources of right upper quadrant pain.