Abdominal pain, RLQ pain, suspicion for appendicitis
Linear and Curvilinear
- You can start where the patient has the worst pain-Ask them to point to where it is with one finger. AKA the “self-localization technique.
- Start with the curvilinear probe to get a global view and then switch to the linear probe when you find the appendix.
- Place the probe in the RLQ and find the edge of the bladder, the iliac vessels will be just deep and lateral to the bladder, scan laterally until you find the cecum, the appendix should be lying just off the tip of the cecum.
- If you can find the epigastric blood vessels and the Iliac vessels the appendix will usually lie in a straight line connecting the 2 groups of vessels.
- If you have trouble finding the appendix have the patient empty his/her bladder as an enlarged bladder can displace the appendix.
- You can also try to put the patient in Trendelenburg to move the small bowel which may obscure the appendix.
- The upper limit of normal for an appendix diameter is 7mm.
- An inflamed appendix will have thickened, layered walls, edema, stranding and will NOT be compressible.