Today, I review, link to, and excerpt from How To Scan Appendix | Ultrasound Probe Positioning | Transducer Placement | Abdominal USG Scanning from Dr. Sam’s Imaging Library.
Jan 21, 2023How To Scan Appendix | Ultrasound Probe Positioning | Transducer Placement | Abdominal USG Scanning
- Use a high frequency (7-12MHz) linear probe.
- Lower frequencies and curvilinear probe can be used in patients with large body habitus.
- Place the probe lateral to the umbilicus in transverse orientation.
- In case of suspected appendicitis, you can place the probe over the area of tenderness. This can help locate the inflamed appendix much faster.
- Apply graded compression to displace bowel gases.
- Locate the psoas muscle.
- Move the probe further to the right of the patient to locate the cecum.
- The small bowel has peristaltic movements whereas cecum and colon do not have peristaltic movements. Move the probe down towards the end of the cecum. The cecum and the appendix have a variable location which is why the right lower quadrant is thoroughly scanned.
- Move downwards and medially to locate iliac vessels.
- Examine the medial and lateral aspects of the cecum.
- The appendix is usually found near the psoas muscle and iliac vessels.
- Adjust the probe accordingly until you locate a target shaped, non-compressible structure. Small bowel is compressible whereas the appendix is non compressible.
- After locating the appendix in transverse view, rotate the probe 90 degrees clockwise to scan in longitudinal plane. An inflamed appendix is much easier to find.