How would you revise an unnecessary multiphase CT request for a child?

Instruction: Choose a justified next examination and explain the protocol change to the referring team and family.

Context: A 10-year-old has persistent right lower quadrant pain, fever, and localized guarding. Ultrasound was nondiagnostic, and the pediatric team remains concerned about appendicitis. MRI is unavailable until the next day. A request arrives for noncontrast, arterial, and portal venous CT of the abdomen and pelvis. There is no additional vascular or other indication for multiple phases.

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I would discuss the ultrasound and current examination with the pediatric team. In this child, ongoing clinical concern and the delay to MRI support CT as a reasonable next test...

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