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Investigators prospectively assessed accuracy of ultrasound for diagnosing appendicitis in 263 children (age range, 4–17 years) who presented to an emergency department in Canada with clinically suspected appendicitis from 2007 through 2008. Ultrasound exams were ordered by treating emergency physicians and performed by sonographers or radiology fellows. Patients with nondiagnostic ultrasound findings received a brief clinical reassessment followed by a second ultrasound, computed tomography (CT), or both, at the discretion of the consulting surgeon.
Ninety-five screening ultrasounds were interpreted as positive, 76 as negative, and 92 as nondiagnostic; 99 patients (37%) had surgically proven appendicitis. Overall, 162 screening ultrasound s…