What is the best imaging test for the diagnosis of acute appendicitis in children?
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What is the best imaging test for the diagnosis of acute appendicitis in children? Evidence-Based Answer: A staged approach using ultrasound (US) followed by CT scan (if the US is equivocal) is effective in diagnosing acute appendicitis (sensitivity 99% and specificity 91%) (SOR: A, systematic review of diagnostic cohort studies and consistent cohort study). Triaging cases with a pediatric appendicitis score (PAS) prior to US and follow-up with CT if the US is equivocal lowers sensitivity to 92% and increases specificity to 95% (SOR: B, prospective cohort trial). Follow-up MRI after an equivocal US has a sensitivity of 100% and a specificity of 96% (SOR: B, retrospective cohort trial).
Evidence-Based Practice 19, no. 5 (2016): 10-11