myRadiologist

Symptom

Suspected appendicitis

ConsiderationsRichard Wasley, MD

study choice depends on age and clinical suspicion. In children <14, ultrasound probably first choice for high and very low clinical suspicion for appy. Equivocal US likely will require CT however. MRI or US for pregnant women.

In adults, CT probably best first choice. IV contrast preferred, but oral contrast not usually necessary unless very thin patient.

§Suggested imagingIn listed order

  1. 01CT abdomen and pelvis with IV contrastCPT 74177
  2. 02CT abdomen and pelvis without IV or oral contrastCPT 74176
  3. 03US right lower quadrantCPT 76775
  4. 04MRI abdomen and pelvis with and without IV gadoliniumSeveral CPT codes