Radiology Surgery

Ultrasound for Appendicitis

This episode of PEM Currents: The Pediatric Emergency Medicine podcast is focused on the use of ultrasound to make the diagnosis of acute appendicitis. You’ll learn about how a right lower quadrant ultrasound is performed, what we look for on the images, how to interpret positive, negative, and intermediate/equivocal results and much more! This episode was co-produced by Liz Lendrum, a senior pediatric resident at Cincinnati Children’s. She developed the learning objectives, compiled the references, and did a stellar job preparing the script and show notes that we used to record this episode. You can follow her on Twitter @liz_lendrum.

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CME & MOC Part 2

We are proud to offer CME and MOC Part 2 from Cincinnati Children’s. Click this link to go to the page for credit. Credit is free and registration is required.

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Appendicits Clinical Scores

Pediatric Appendicitis Score – MD Calc

Alvarado Score for Acute Appendicitis – MD Calc

Pediatric Appendicitis Risk Calculator – MD Calc


Kharbanda AB, Vazquez-benitez G, Ballard DW, et al. Development and Validation of a Novel Pediatric Appendicitis Risk Calculator (pARC). Pediatrics. 2018;141(4).

Cotton DM, Vinson DR, Vazquez-benitez G, et al. Validation of the Pediatric Appendicitis Risk Calculator (pARC) in a Community Emergency Department Setting. Ann Emerg Med. 2019.

Samuel M. Pediatric Appendicitis Score. Journal of Pediatric Surgery, Vol 37,No 6 (June),2002: pp 877-881.

Goldman RD. The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain. Evid Based Med 2009;14:26 doi:10.1136/ebm.14.1.26

Kharbanda, AB. Validation and Refinement of a Prediction Rule to Identify Children at Low Risk for Acute Appendicitis. Arch Pediatr Adolesc Med 2012;166(8):738-744. doi:10.1001/archpediatrics.2012.490

Shah SR, Sinclair KA, Theut SB, Johnson KM, Holcomb GW 3rd, St Peter SD. Computed Tomography Utilization for the Diagnosis of Acute Appendicitis in Children Decreases With a Diagnostic Algorithm. Ann Surg. 2016 Sep;264(3):474-81.

Becker C, Kharbanda A. Acute appendicitis in pediatric patients: an evidence-based review. Pediatr Emerg Med Pract. Sep 2019;16(9):1-20.

Trout AT, Towbin AJ, Fierke SR, Zhang B, Larson DB. Appendiceal diameter as a predictor of appendicitis in children: improved diagnosis with three diagnostic categories derived from a logistic predictive model. Eur Radiol. Aug 2015;25(8):2231-8. doi:10.1007/s00330-015-3639-x

Anandalwar SP, Callahan MJ, Bachur RG, et al. Use of White Blood Cell Count and Polymorphonuclear Leukocyte Differential to Improve the Predictive Value of Ultrasound for Suspected Appendicitis in Children. J Am Coll Surg. Jun 2015;220(6):1010-7. doi:10.1016/j.jamcollsurg.2015.01.039

Gendel I, Gutermacher M, Buklan G, et al. Relative value of clinical, laboratory and imaging tools in diagnosing pediatric acute appendicitis. Eur J Pediatr Surg. Aug 2011;21(4):229-33. doi:10.1055/s-0031-1273702

By bradsobo

Brad Sobolewski, MD, MEd is an Associate Professor of Pediatric Emergency Medicine and an Associate Director for the Pediatric Residency Training Program at Cincinnati Children's Hospital Medical Center. He is on Twitter @PEMTweets and authors the Pediatric Emergency Medicine site PEMBlog and produces and hosts the PEM Currents: The Pediatric Emergency Medicine Podcast.

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