Imaging Stewardship for the diagnosis of pediatric appendicitis: Improved ultrasound performance can decrease emergency department length of stay

jpedsurg.org

When ultrasound (US) is non-diagnostic in pediatric patients being evaluated for appendicitis, additional imaging may be required, which incurs delays and increased cost in diagnosis. Our baseline diagnostic rate of US for appendicitis was 27.1 % and was lower for patients with moderate pediatric appendicitis scores (PAS). Due to poor US performance, in our original pathway, patients with moderate PAS underwent magnetic resonance imaging (MRI) initially, resulting in increased emergency department length of stay (ED LOS).

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Article · Nov 2025 · 1 min read

In brief

This study examines how improving ultrasound diagnostic performance for pediatric appendicitis can reduce emergency department length of stay. By enhancing ultrasound accuracy, particularly in patients with moderate appendicitis scores, the need for additional MRI imaging and associated delays can be minimized.

Baseline ultrasound diagnostic rate for pediatric appendicitis was only 27.1%, particularly poor in moderate PAS patients
Non-diagnostic ultrasound requires additional imaging (MRI), increasing ED length of stay and healthcare costs
Improving ultrasound performance can reduce need for MRI and decrease emergency department delays in appendicitis workup

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