Graded-compression ultrasound of the right iliac fossa
Right iliac fossa; pelvis and both renal tracts as indicated
When to use it
- Suspected appendicitis in a child or adolescent.
- Suspected appendicitis in pregnancy, as the first step before MRI.
- Slim young adults where dose avoidance is a priority.
Technique
- Graded compression displaces bowel gas; the psoas and iliac vessels are the landmarks for the retrocaecal appendix.
Where it goes wrong
- A non-visualised appendix is NOT a negative study — it must be reported as non-diagnostic so the pathway escalates rather than terminating.
- A normal proximal appendix does not exclude distal (tip) appendicitis.
Clinical questions that reach this study
Contrast
None