Paeds Cases · investigations-procedures-and-technology
Acute abdominal imaging decision — OSCE
OSCE procedural station: assess an 8-year-old child with suspected appendicitis, define the clinical question that the imaging must answer, choose the first-line modality, apply the ALARA principle, and outline the pathway for the equivocal case and the contrast-study scenario.
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RACP DCEMRCPCH ClinicalRCPSC PediatricsABP General Pediatrics
Prompt
An 8-year-old boy is brought to the emergency department with an 18-hour history of central abdominal pain that has migrated to the right iliac fossa, anorexia, and a low-grade fever of 38.2 degrees Celsius. He is alert and perfusing well, with focal tenderness and voluntary guarding in the right lower quadrant. The registrar asks you to outline the imaging decision, the role of the abdominal radiograph, and the next steps.
Candidate brief
You are the paediatric registrar in the emergency department. An 8-year-old boy presents with an 18-hour history of central abdominal pain migrating to the right iliac fossa, anorexia, and a low-grade fever. He is alert and perfusing well, with focal tenderness and voluntary guarding in the right lower quadrant. The registrar asks you to outline the imaging decision. [3]
References6ShowHide
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- [2]Frush DP, Goske MJ Image Gently: toward optimizing the practice of pediatric CT through resources and dialogue Pediatric Radiology, 2015.PMID 25680878
- [3]Koberlein GC, Trout AT, Rigsby CK, et al ACR Appropriateness Criteria: Suspected Appendicitis-Child Journal of the American College of Radiology, 2019.PMID 31054752
- [4]Kharbanda AB, Vazquez-Benitez G, Ballard DW, et al Development and Validation of a Novel Pediatric Appendicitis Risk Calculator (pARC) Pediatrics, 2018.PMID 29535251
- [5]Daneman A, Navarro O Intussusception. Part 1: a review of diagnostic approaches Pediatric Radiology, 2003.PMID 12557062
- [6]Choi G, Je BK, Kim YJ Gastrointestinal Emergency in Neonates and Infants: A Pictorial Essay Korean Journal of Radiology, 2022.PMID 34983099