Changes

==Choice of initial exam==In suspected appendicitis:*'''Ultrasonography ''' is the first choice of exam. In children, it gives a proper diagnosis in the vast majority even in obese children.<ref>{{cite web|url=https://www.uptodate.com/contents/acute-appendicitis-in-children-diagnostic-imaging|title=Acute appendicitis in children: Diagnostic imaging|author=George A Taylor, David E Wesson|accessdate=2018-06-25|website=UpToDate}} Last updated Apr 30, 2018</ref> In adults, it is often inconclusive, but is still recommended as a first imaging choice when symptoms indicate the condition.<ref name="MostbeckAdam2016">{{cite journal|last1=Mostbeck|first1=Gerhard|last2=Adam|first2=E. Jane|last3=Nielsen|first3=Michael Bachmann|last4=Claudon|first4=Michel|last5=Clevert|first5=Dirk|last6=Nicolau|first6=Carlos|last7=Nyhsen|first7=Christiane|last8=Owens|first8=Catherine M.|title=How to diagnose acute appendicitis: ultrasound first|journal=Insights into Imaging|volume=7|issue=2|year=2016|pages=255–263|issn=1869-4101|doi=10.1007/s13244-016-0469-6}}</ref> If inconclusive, further evaluation can be done by reassessment by the clinician, as well as complementary imaging with MRI or CT.<ref name="MostbeckAdam2016"/>*[[CT of appendicitis|'''CT''' of appendicitis]] is the preferable initial method in the elderly, who are less likely to develop adverse effects from the radiation dose.<ref name="HuiMajor2002">{{cite journal|last1=Hui|first1=Thomas T.|last2=Major|first2=Kevin M.|last3=Avital|first3=Itzhak|last4=Hiatt|first4=Jonathan R.|last5=Margulies|first5=Daniel R.|title=Outcome of Elderly Patients With Appendicitis|journal=Archives of Surgery|volume=137|issue=9|year=2002|issn=0004-0010|doi=10.1001/archsurg.137.9.995}}</ref> It is also indicated as initial exam in adults with more non-specific acute abdominal symptoms.