Nonoperative treatment of early, uncomplicated appendicitis is increasingly being explored, and imaging plays a role in identifying candidates for nonoperative management [2]. Imaging has been shown to facilitate management and decrease the rate of negative appendectomies in children with suspected acute appendicitis [7-10] and remains a central tool in the diagnosis of pediatric acute appendicitis. Special Imaging Considerations This document aims to provide guidance related to the imaging technique(s) best suited for the diagnosis of acute appendicitis. Importantly, this document does not encompass the appropriate imaging of all potential causes of RLQ quadrant pain. While this guideline emphasizes the role of imaging in the diagnosis of acute appendicitis in children, the initial consideration for imaging is based on clinical assessment. Clinical scoring systems and clinical pathways based upon history, symptoms, physical examination, and laboratory findings have been developed to risk stratify regarding the diagnosis of acute appendicitis and to guide imaging, clinical management, and surgery [11-14]. Two of the more widely used scoring systems are the Alvarado Score and Pediatric Appendicitis Score [13,15]. As primary diagnostic tools, clinical scoring systems have been shown to The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org perform variably well depending on the population and often perform less well than imaging or a combination of scoring and imaging [13,15].
Suspected Appendicitis Child. Nonoperative treatment of early, uncomplicated appendicitis is increasingly being explored, and imaging plays a role in identifying candidates for nonoperative management [2]. Imaging has been shown to facilitate management and decrease the rate of negative appendectomies in children with suspected acute appendicitis [7-10] and remains a central tool in the diagnosis of pediatric acute appendicitis. Special Imaging Considerations This document aims to provide guidance related to the imaging technique(s) best suited for the diagnosis of acute appendicitis. Importantly, this document does not encompass the appropriate imaging of all potential causes of RLQ quadrant pain. While this guideline emphasizes the role of imaging in the diagnosis of acute appendicitis in children, the initial consideration for imaging is based on clinical assessment. Clinical scoring systems and clinical pathways based upon history, symptoms, physical examination, and laboratory findings have been developed to risk stratify regarding the diagnosis of acute appendicitis and to guide imaging, clinical management, and surgery [11-14]. Two of the more widely used scoring systems are the Alvarado Score and Pediatric Appendicitis Score [13,15]. As primary diagnostic tools, clinical scoring systems have been shown to The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org perform variably well depending on the population and often perform less well than imaging or a combination of scoring and imaging [13,15].