Don’t do CT for the evaluation of suspected appendicitis in children until after ultrasound has been considered as an option.
|Rationale and Comments:||Although CT is accurate in the evaluation of suspected appendicitis in the pediatric population, ultrasound is the preferred initial consideration for imaging examination in children. If the results of the ultrasound exam are equivocal, it may be followed by CT. This approach is cost-effective, reduces potential radiation risks and has excellent accuracy, with reported sensitivity and specificity of 94% in experienced hands. Recognizing that expertise may vary, strategies including improving diagnostic expertise in community-based ultrasound and the development of evidence-based clinical decision rules are realistic goals in improving diagnosis without the use of CT scan.|
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