CT Scan? We Don't Need a Stinkin' CT Scan

No, contrary to popular belief the girl in the picture isn't constipated or having cramps. She has an acute appendicitis.



Traditionally, she will have an aversion to food, some degree of nausea/abdominal upset and pain in the right lower quadrant... necessitating some labs studies and a CT scan to document inflammation in the appendix.

This is all well and good... but what if there were another way? There just may be... and it may come in the form of the good 'ol urinalysis.


The MedPage Today is reporting on an article in the Annals of Emergency Medicine that shows how acute appendicitis can be diagnosed by detecting biomarkers in the urine. The study was done in children but is likely to be as effective in the adult population. In particular it is the leucine-rich alpha-2-glycoprotein (LRG) which was both specific and sensitive as a marker of appendicitis. Moreover, levels of LRG correlated with the severity of the appendicitis... all without the radiation exposure of a CT scan.


The method of detection of LRG also lends itself to a possible convenient dipstick test. More studies will be needed, particularly within the adult population. But, this may be an exciting advance.