The sonographic evaluation of patients suspected of harboring acute appendicitis is mentioned here primarily as a cautionary note. The finding of a noncompressible appendix greater than 6 mm in diameter has been found to be helpful in making the diagnosis of appendicitis in the appropriate clinical setting. 18 However, several aspects of this examination make it particularly unsuited for performance by emergency physicians. This examination is generally quite time consuming, requires specialized training and experience, and can be very difficult technically. The diagnosis of appendicitis is also not as critically time dependent, as are such entities as ruptured AAA or hemoperitoneum in a trauma patient, and generally is best left in the hands of sonologists trained in this technique. Other potential uses for bedside ultrasound in the ED can be found in standard emergency ultrasound texts.
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