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To study the clinical impact of a new pediatric appendicitis imaging pathway instituted at a pediatric emergency department (ED) in New York, investigators retrospectively reviewed data for children <18 years of age who underwent imaging for suspected appendicitis during 2-year periods before and after initiation of the pathway. In the first 2 years, computed tomography (CT) with oral and intravenous contrast was the primary imaging modality. In the subsequent 2 years, the new algorithm utilized ultrasound as the first choice, followed by magnetic resonance imaging (MRI) for children >5 years of age with inconclusive ultrasound results.
Of 662 children (mean age, 12 years), 265 presented before the algorithm was instituted, and 397 presented…