• Rationale and Comments

    Although CT is the most accurate radiologic modality for the evaluation of appendicitis, ultrasound should be the preferred initial evaluation in children. This modality is cost effective, avoids radiation exposure, and has excellent accuracy, with a reported sensitivity and specificity of 94% in experienced hands. When the ultrasound is equivocal, decision guidelines based on clinical findings as well as radiologic findings may assist in determining the need for cross-sectional imaging. Other options to consider prior to CT scan may include an evaluation by a surgeon, observation with serial exams, repeat ultrasound after a period of observation, and MRI, which has been shown to have similar diagnostic accuracy as CT.

    Sponsoring Organizations

    • American Academy of Pediatrics – Section on Surgery


    • American College of Radiology guidelines


    • Pediatric
    • Surgical


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