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Investigators at a single academic institution prospectively evaluated the accuracy of emergency department ultrasound for identifying acute appendicitis in children. After attending a 45-minute lecture and performing five studies under supervision, one pediatric emergency medicine attending physician and 12 fellows performed bedside ultrasound studies. A positive study result was defined as visualization of an appendix greater than 6 mm in diameter; however, in the absence of this, the presence of an appendicolith, free fluid, periappendiceal inflammation, or sonographic McBurney's sign could also be considered a positive finding. Treating physicians were blinded to the findings of the bedside scans.
Over three years, 231 children (median a…