Tuesday, January 21, 2014

Appendicitis: Ultrasound And Multi-Modalities

I have always been an advocate of using ultrasound in the diagnosis of appendicitis.  In children, the use is a first defense.  Sure we can get lab work, and search for McBurney's sign.  I think the use of CT scanners is a burden on the patient's financial resources in a time of health care reform chaos.  We should learn to use ultrasound as a valid and very useful (and economically conservative) way to help out in acute and chronic situations.  The use of these big machines like CT and MRI are more useful in other situations.  There is nothing better than a good surgeons touch, but it is expensive at 3:00 am.  Though I will not volunteer to pull call at a hospital, or doc-in-the-box (too old and cranky), I would argue that up and coming sonographers put the scrubs on and go out to look for these lesions which are common.  I made my own DX of appendicitis 21 years ago with clinical and sonographic means.  I saved my own life with the help of a great surgeon.  He told me I was at the doorstep of death.  Yes I imaged my own appendicitis, though I do not remember.  Friends at the hospital I worked in said you were wise to come in and present as an acute patient.  They later told me I was a nasty patient.  I would hate to see a child suffer what I suffered, and not be treated correctly.  Here is an article that melds diagnostic imaging with the wonder tools a medical doctor has.  Peace TJW

FRIDAY, Jan. 3, 2014 (HealthDay News) -- A clinical pathway combining the Samuel's pediatric appendicitis score (PAS) and selective use of ultrasonography (US) has high sensitivity and specificity for diagnosing appendicitis in children, according to a study published online Dec. 30 in Pediatrics.

http://www.doctorslounge.com/index.php/news/pb/43512

Thanks Doctors Lounge
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