Finding the appendix on ultrasound webinar for sonographers

In this webinar, Matlack reviews what the appendix does and where you should look for it, including the anatomy you can expect to see in the area that can be confusing. He describes the appearance of a normal and abnormal appendix, which can help you determine if the patient has early-onset appendicitis, or if something else is going on, such as a perforated appendix.

If you’re struggling to see the appendix due to bile and gas clouding the view, there are maneuvers and positions that give you a better chance of finding it, as well as different scanning techniques that could help you locate it, including graded compression and posterior compression. He shows images that differentiate between the bowel in the RLQ and the appendix, for example. He also reviews secondary signs of appendicitis and shows examples of the kinds of images needed for the radiologist to make a diagnosis.

According to Matlack, many sonographers struggle with knowing if they’ve looked for the appendix long enough. He offers advice about switching to a curved probe and recommends taking eight key images to show the radiologist. In total, he says it should take 10-20 minutes to get the necessary images and to get an idea of whether there is an inflammatory process, even if you can’t find the appendix itself.