Radiation-Free Diagnosis of Pediatric Appendicitis Accuracy of Point-of-Care Ultrasonography and Magnetic Resonance Imaging

Joshua Davis, Melissa Chima, Kathryn Kasmire

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Introduction: Appendicitis is a common pediatric surgical emergency, and it can often be difficult to diagnose. Computed tomography is commonly used as a diagnostic criterion standard, but herein, we describe the accuracy of a "radiation-free"diagnostic algorithm using point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to diagnose pediatric appendicitis. Methods: This was a retrospective chart review of all patients who had a POCUS ordered for evaluation of pediatric appendicitis. Results of POCUS and MRI were classified as positive, negative, or equivocal using previously described cutoffs and criterion standard of surgery/pathology or clinical follow-up. Diagnostic accuracy was calculated using traditional methods. Results: We identified 209 patients for inclusion. The sensitivity and specificity of POCUS were 100% and 95.2%, respectively, in addition to 86 equivocal examinations, 6 of which had appendicitis. The sensitivity and specificity of MRI were 94.4% and 96.5%, respectively, in addition to 27 equivocal examinations, 2 of which had appendicitis. Conclusions: Using POCUS and MRI for the diagnosis of pediatric appendicitis is a highly accurateway to avoid ionizing radiation in children. In our study, POCUS is as accurate as MRI, although this is limited by being mostly done by a single provider and a high number of equivocal examinations.

Original languageEnglish (US)
Pages (from-to)E246-E250
JournalPediatric Emergency Care
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2022

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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