SELF-LOCALIZATION IN US OF APPENDICITIS - AN ADDITION TO GRADED COMPRESSION

Graded-compression ultrasound (US) of the right lower quadrant (RLQ) h as been a valuable addition to the diagnostic evaluation of acute appe ndicitis. In an effort to expedite the sonographic evaluation and impr ove diagnostic accuracy, a method of self-localization was added to th e standard graded-compression examination. A total of 236 patients wit h signs of appendicitis were studied. Eighty-five percent (121 of 142) of the patients with proved appendicitis were able to decisively self -localize their pain. Of the patients without appendicitis who still h ad significant disease in the RLQ, 88% (29 of 33) were able to self-lo calize their pain, with an accuracy rate of 86% for significant diseas e. Among patients without significant disease, only 15% (nine of 61) s elf-localized their pain. This ''sonographic self-localization sign'' reduced the time of the examination and was a valuable addition to sta ndard graded-compression US of the appendix.