Ultrasonography for the diagnosis of appendicitis..

Diagnostic Imaging: Ultrasound: Findings in Appendicitis.

The sonographic diagnosis of acute appendicitis is based on identification of a tubular, noncompressible, aperistaltic bowel loop, which demonstrates a connection with the cecum and a distal blind end, with a diameter greater than 6 mm

ultrasound of the right lower quadrant with the appendix showing the "target" sign seen in acute appendicitis..

Graded compression ultrasonography is one of the two imaging modalities commonly used in the assessment of 

clinically suspected appendicitis..

This self-localization technique has a sensitivity of 85%, specificity of 60%, and accuracy of 75% in diagnosing appendicitis. The overall accuracy of this technique in diagnosing appendicitis as well as other significant disease processes which may clinically mimic appendicitis is 86%. However, the self-localization technique is of limited value with retrocecal or perforated appendicitis due to the patient's inability to accurately localize the pain (21).

Based on the data of several recent studies, CT performed for clinical suspicion of appendicitis with atypical symptoms has a sensitivity of 87 - 96%, specificity of 89 - 97%, positive predictive value of 95%, negative predictive value of 95%, and accuracy of 94% (27,29).

Perforated appendix with local peritonitis

inflammed appendix with echogenic edematous omentum around

acute appendicitis

Retrocaecal appendix

retrocaecal appendix showing target sign.

Inflammed tip of the appendix.