ACR Appropriateness Criteria ((R)) Right Upper Quadrant Pain

UMMS Affiliation

Department of Radiology

Publication Date


Document Type



Body Regions | Diagnosis | Equipment and Supplies | Health Services Administration | Health Services Research | Radiology


Although right upper quadrant pain is a very common clinical presentation, it can be nonspecific. However, acute cholecystitis is very often the diagnosis of exclusion. This review focuses on the recommended imaging evaluation in the most commonly encountered clinical scenarios presenting with right upper quadrant abdominal pain, including suspected biliary disease, suspected acute cholecystitis, and suspected acalculous cholecystitis. This document hopes to clarify the appropriate utilization of the many imaging procedures that are available and commonly employed in these clinical settings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.


AUC, Appropriate Use Criteria, Appropriateness Criteria, Cholecystitis, Cholelithiasis, Cholescintigraphy, Complicated cholecystitis, MRCP, Right upper quadrant pain

DOI of Published Version



J Am Coll Radiol. 2019 May;16(5S):S235-S243. doi: 10.1016/j.jacr.2019.02.013. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American College of Radiology : JACR


Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID