Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
Table 1
Overview of studies evaluating integration of ultrasound with clinical parameters for pediatric appendicitis.
Study
Patients (N)
Integration with
Conclusion
Athans et al.
776
Alvarado PAS
If equivocal US examination was used, a low clinical score (≤5) may be used to identify patients with a low likelihood of appendicitis.
Bachur et al.
728
PAS
False-negative US increase with increasing PAS, and false-positive US occur more often with lower PAS. Discordance between US results and clinical assessment warrants serial examinations or further imaging.
Blitman et al.
522
Alvarado
Children with inconclusive US and low Alvarado score (<5) are extremely unlikely to have appendicitis.
Toprak et al.
122
Alvarado
In children with a nonvisualized appendix and without a high Alvarado score, appendicitis can be safely ruled out.
Zouari et al.
292
Alvarado CRP
Integration of Alvarado score and ultrasound improve the predictive values of diagnosing appendicitis.
Anandalwar et al.
845
WBC count PMN
Integration of US with WBC count and PMN% can substantially improve the predictive values of diagnosing appendicitis.
