Question

Radiological evaluation of acute appendicitis.

Hint:

Use ultrasound as the first-line imaging technique for suspected acute appendicitis, especially in children and pregnant women. If the diagnosis is unclear, CT or MRI can provide more detailed information.

Answer 1

Step 1: Understanding Acute Appendicitis.
Acute appendicitis is a common condition that causes inflammation of the appendix, leading to abdominal pain and other symptoms. Early diagnosis is crucial to avoid complications like perforation. Radiological imaging plays a vital role in confirming the diagnosis, especially when clinical findings are ambiguous.

Step 2: Radiological Imaging Techniques for Acute Appendicitis.
1. Ultrasound (US): The first-line imaging modality in children and pregnant women due to its non-invasive nature. The key features of appendicitis on ultrasound include a non-compressible, enlarged appendix with a diameter greater than 6 mm, often with surrounding fluid or free air.
2. CT Scan (Computed Tomography): CT is highly sensitive and provides a detailed view of the appendix and surrounding structures. The findings in acute appendicitis typically include: - An enlarged, thickened appendix (>6 mm in diameter). - Inflammation around the appendix, which may include fat stranding. - Presence of appendicoliths (calcified deposits in the appendix). - Perforation or abscess formation in advanced cases.
3. MRI (Magnetic Resonance Imaging): MRI is an alternative to CT, particularly in pregnant women or those who need to avoid radiation. MRI shows similar features to CT, such as an enlarged appendix, peri-appendiceal fluid, and fat stranding.

Step 3: Conclusion.
Radiological imaging, especially ultrasound, CT, and MRI, plays a critical role in diagnosing acute appendicitis. Timely imaging helps in confirming the diagnosis and avoiding unnecessary surgeries or complications.