Abdominal Pain in the Emergency Department: How to Select the Correct Imaging for Diagnosis

Carmen Wolfe,1 Maglin Halsey-Nichols,2 Kathryn Ritter,3 Nicole McCoin4 1Department of Emergency Medicine, TriStar Skyline Medical Center, Nashville, TN, USA; 2Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA; 4Department of Emergency Medicine, Ochsner Medical Center, New Orleans, LA, USACorrespondence: Carmen Wolfe, Department of Emergency Medicine, TriStar Skyline Medical Center, 3443 Dickerson Pike, Suite 550, Nashville, TN, USA, Tel +1 615 426 4692, Fax +1 615 860 5229, Email Carmen.wolfe@hcahealthcare.comAbstract: Abdominal pain is a common presenting complaint in the emergency department, and utilization of diagnostic imaging is often a key tool in determining its etiology. Plain radiography has limited utility in this population. Computed tomography (CT) is the imaging modality of choice for undifferentiated abdominal pain. Ultrasound and magnetic resonance imaging may be helpful in specific scenarios, primarily in pediatrics and pregnancy, and offer the benefit of eliminating ionizing radiation risk of CT. Guidance for imaging selection is determined by location of pain, special patient considerations, and specific suspected etiologies. Expert guidance is offered by the American College of Radiology Appropriateness Criteria® which outlines imaging options based on location of pain.Keywords: computed tomography, ultrasound, radiograph, appendicitis