Ultrasound and Alvarado score may stratify pediatric appendicitis risk

Wednesday, November 30 | 10:50 a.m.-11:00 a.m. | SSK14-03 | Room S102AB
In this scientific paper presentation, researchers will describe how the combination of focused appendicitis ultrasound (FAUS) and Alvarado score may help diagnose pediatric appendicitis.

With the need to reduce unnecessary CT scans in children becoming a major focus in the radiology community in recent years, the study aimed to identify patients at low risk for appendicitis and therefore unlikely to benefit from additional CT imaging, according to presenter Dr. Netta Blitman of Montefiore Medical Center.

The researchers retrospectively reviewed the ultrasound, CT, clinical, and laboratory findings from 522 consecutive children who received FAUS for abdominal pain at the institution's pediatric emergency department between January 2008 and October 2009. At Montefiore, focused appendicitis ultrasound is the first study performed on children presenting with right lower quadrant pain.

The study team found that approximately 75% of the FAUS studies are inconclusive for appendicitis, with the remainder either positive or normal. An inconclusive FAUS study and a low Alvarado score had a negative predictive value of 99.6%.

"Combining FAUS with Alvarado score was shown to identify children who have or are at very low risk for appendicitis," Blitman said. "This may substantially reduce unnecessary CT examinations."

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