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Primary survey
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  1. Steve Goodacre

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      CT FOR APPENDICITIS

      In our June issue, Jerry Baskerville presented a powerful argument for considering the risks of radiation involved in multi-detector computed axial tomography (MDCT). In this issue, Kim and colleagues present a flipside to the argument. They used MDCT to evaluate 157 patients with suspected appendicitis and found that 20 out of 75 with clinically evident appendicitis had negative MDCT, 19 of whom successfully avoided surgery. Meanwhile, 40 out of 86 without clinically evident appendicitis had positive MDCT, of whom 38 underwent operation with only one negative appendectomy. These findings suggest that MDCT could reduce the risk of negative appendectomy. A controlled trial could confirm this potential, while modelling would help determine whether the potential benefits justify the costs and radiation risks (see page 477).

      ULTRASOUND FOR ABDOMINAL PAIN

      Emergency physicians will be familiar with debate over the use of diagnostic ultrasound by non-radiologists. Lindelius and colleagues evaluated whether the accuracy of diagnosis …

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