RGUHS Nat. J. Pub. Heal. Sci Vol No: 10 Issue No: 1 eISSN: 2584-0460
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1Dr. Srinag Gonchikar, Junior resident final year Radio diagnosis, KVG Medical College, Sullia, Karnataka, India.
2Professor and HOD, Department of Radiodiagnosis, KVGMC, Karnataka, India
3Senior Resident, KVGMC, Karnataka, India
*Corresponding Author:
Dr. Srinag Gonchikar, Junior resident final year Radio diagnosis, KVG Medical College, Sullia, Karnataka, India., Email: srinag.gk@gmail.com
Abstract
Background: This study aimed to evaluate the role of non-invasive imaging modalities, specifically ultra-sonography (USG) and computed tomography (CT), in the timely diagnosis and management of right iliac fossa (RIF) pain in young patients.
Methods: A prospective study was conducted in the Department of Radiodiagnosis at K.V.G Medical College. One hundred patients presenting with RIF pain were evaluated using USG, with CT performed in select cases. USG was performed using high-frequency linear and convex transducers, with CT reserved for complex cases. Surgical findings were used as the gold standard for correlation with imaging results.
Results: The study population comprised 83% females and 17% males, with majority aged 20-29 years. USG findings identified appendicitis in 30% of cases, ovarian cysts in 19%, and ectopic pregnancy in 8% of cases. Surgical findings confirmed appendicitis in 53% of cases, ovarian cysts in 21%, and ectopic pregnancy in 11% of cases. The sensitivity and specificity of USG for appendicitis were 100% and 97.22%, respectively, while for ectopic pregnancy, both sensitivity and specificity were 100%. Ovarian cysts were diagnosed with 100% sensitivity and 97.59% specificity. CT was used in two cases to confirm cystadenoma.
Conclusion: USG is a highly reliable, non-invasive, and cost-effective imaging modality for evaluating RIF pain in young patients, particularly in cases of appendicitis, ectopic pregnancy, and ovarian cysts. Its high diagnostic accuracy, coupled with the absence of ionizing radiation, makes it the preferred choice for young and pregnant patients. CT, while less frequently used, remains valuable in complex cases.
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Article
Introduction
Non-invasive imaging modalities such as ultra-sonography (USG) and computed tomography (CT) are essential for timely diagnosis and management of pain in the right iliac fossa (RIF), avoiding unnecessary surgical intervention.1,2 Both CT and USG can be used for image-guided drainage or aspiration of abscesses complicating conditions in the right lower quadrant.
This study was undertaken with the aim of evaluating the role of non-invasive imaging modalities, specifically USG and CT, in the timely diagnosis and management of RIF pain in young patients.3
Materials and Methods
This study was conducted in the Department of Radiodiagnosis, KVG Medical College.
Selection of cases
The present study included a series of 100 cases diag-nosed with right iliac fossa pain and were referred from the Departments of Surgery, Obstetrics & Gynaecology, and Medical Emergency from both inpatient and outpatient departments.
Study design
Cross-sectional study design
Sampling
Consecutive sampling
Results & Discussion
The study population was evaluated using ultrasound with a 7.5-10 MHz linear array transducer and a 3.5 MHz convex transducer. Helical CT scan was done only for two patients.The percentage of different pathologies causing right iliac fossa pain in young patients (15-35 years), as identified in the present study using ultrasonography, is listed in Table 1.
The diagnoses in all 100 young patients studied with USG were confirmed by surgical findings. Appendicitis was the most common (53%), followed by ovarian cysts (21%) and ectopic pregnancy (11%) (Table 2).
A statistically significant association was established between the USG findings and surgical findings (P value <0.001 using Pearson’s Chi square test for independent of attributes). The major types of findings were used to calculate sensitivity and specificity, yielding the following results.The correla-tion between ultrasonography and CT findings with surgical findings was analyzed (Table 3).
The overall sensitivity and specificity of ultrasono-graphy for diagnosing appendicitis were 100% and 97.22%, respectively (Table 4). Sonographic sensitivity and specificity for ectopic pregnancy were 100%.3,4 In diagnosing ovarian cysts, sonography demonstrated a sensitivity and specificity of 100% and 97.59%, respectively.5-7
Conclusion
The present study found that appendicitis is the most common pathology for right iliac fossa pain in young patients. The non-invasive nature, safety, and reliability of ultrasonography make it the diagnostic method of choice in pregnant women suffering from pelvic pain/ RLQ pain. The false positive percentage for appendicitis was 2%, with a diagnostic accuracy of 98%. Imaging methods, such as ultrasound (USG) and computed tomography (CT), are aimed at avoiding misdiagnosis and facilitating earlier surgery when necessary. These methods have become increasingly important for decreasing the morbidity of the disease. Advantages of USG include low cost, lack of ionizing radiation or need for preparation and the ability to provide dynamic information through graded compression. The present study revealed that USG had a diagnostic accuracy of 98% for appendicitis, 100% for ectopic pregnancy, 98% for ovarian cysts and 77% for normal status. The non-invasive nature, safety, and reliability of ultrasonography make it the preferred diagnostic method for young patients and pregnant women.
Conflict of Interest
Nil
Supporting File
References
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