General Diagnoses Practice Test

Imaging in pediatric suspected appendicitis is guided by balancing diagnostic accuracy with minimizing radiation exposure. Ultrasound is the initial test because it avoids radiation and, when done by an experienced operator, can identify appendicitis by showing a noncompressible, blind-ending tubular structure larger than about 6 mm, often with surrounding signs of inflammation. It also helps distinguish other causes of pain in the lower abdomen. If the ultrasound is nondiagnostic or equivocal, a CT scan is used to improve sensitivity, accepting the trade-off of ionizing radiation. MRI is a radiation-free alternative with good accuracy, but it is less widely available and can be less practical in acute settings. X-ray is not useful for diagnosing appendicitis.