Portable ultrasound is an excellent first-line choice for diagnosing appendicitis in children, according to an article published online February 10 in Academic Emergency Medicine.
Bedside ultrasound delivered a specificity of 94% and reduced the need for CT scans by more than a third, according to study co-author Dr. Ee Tein Tay, assistant professor of emergency medicine and pediatrics at the Icahn School of Medicine at Mount Sinai.
CT is the most accurate imaging modality for diagnosing appendicitis, but it delivers a potentially harmful radiation dose, particularly in children. As a result, efforts are underway to reduce the 4 million radiation-emitting scans given to children each year.
The prospective, observational study included 150 pediatric patients who were evaluated for suspected appendicitis between May 2011 and October 2012 in an urban pediatric emergency department.
Use of portable ultrasound reduced the CT scanning rate by more than 35% -- from a 44% rate before the study to 27% during the study.
In addition, the emergency department length of stay declined 46% (by two hours and 14 minutes) for those undergoing radiology department ultrasound. Length of stay decreased by 68% (almost six hours) for those who required CT after an initial point-of-care ultrasound was inconclusive.
No cases of appendicitis were missed with the use of first-line ultrasound, and no unnecessary surgeries were performed for a normal appendix.
