Variant 1: Screening, first study.
Variant 2: Positive localized or regional symptoms. Radiographs negative or findings do not explain symptoms.
Variant 3: Lesion on radiographs definitively benign. Not osteoid osteoma.
Variant 4: Lesion on radiographs. Radiographic and/or clinical pattern suspicious for osteoid osteoma.
Variant 5: Lesion on radiographs. Indeterminate for malignancy with mineralized matrix.
Variant 6: Lesion on radiographs. Indeterminate for malignancy. Lytic lesion.
Variant 7: Lesion on radiographs. Indeterminate for malignancy. Sclerotic or mixed lytic/sclerotic lesion.
Variant 8: Lesion on radiographs. Aggressive, suspicious for malignancy.
Variant 9: Lesion with pathological fracture on radiographs. Not definitively benign.
Variant 10: No radiographs. “Incidental” finding on MRI. Not clearly benign.
Variant 11: No radiographs. “Incidental” finding on CT. Not clearly benign.
Appendix Key

A more complete discussion of the items presented below can be found by accessing the supporting documents at the designated hyperlinks.

Appropriateness Category:The panel’s recommendation for a procedure based on the assessment of the risks and benefits of performing the procedure for the specified clinical scenario.

SOE: Strength of Evidence. The assessment of the amount and quality of evidence found in the peer reviewed medical literature for an appropriateness recommendation.

  • References: The citation number and PMID for the reference(s) associated with the recommendation.
  • Study Quality: The assessment of the quality of an individual reference based on the number of study quality elements described in the reference.

RRL: Relative Radiation Level. A population based assessment of the amount of radiation a typical patient may be exposed to during the specified procedure.

Rating: The final rating (1-9 scale) for the procedure as determined by the panel during rating rounds.

Median: The median rating (1-9 scale) for the procedure as determined by the panel during rating rounds.

Final tabulations: A histogram showing the number of panel members who rated the procedure as noted in the column heading (ie, 1, 2, 3, etc.).

Additional supporting documents about the AC methodology and processes can be found at