Acute appendicitis - There's an app for that

By Bernie Monegain
09:02 AM

Radiologists can accurately diagnose acute appendicitis from a remote location with a mobile phone equipped with special software, according to a study presented Monday at the annual meeting of the Radiological Society of North America.

"The goal is to improve the speed and accuracy of medical diagnoses as well as to improve communications among different consulting physicians," said Asim F. Choudhri, MD, a physician in the division of neuroradiology at Johns Hopkins University in Baltimore and the study's lead auithor.

"When we can make these determinations earlier, the appropriate surgical teams and equipment can be assembled before the surgeon even has the chance to examine the patient," he said.

Choudhri and his fellow researchers used an iPhone for the study of 15 patients.

Appendicitis – inflammation and infection of the appendix – is a medical emergency requiring surgical removal of the organ. Undiagnosed or left untreated, the inflamed appendix will rupture, causing toxins to spill into the abdominal cavity and potentially creating a life-threatening infection. Appendicitis can occur at any age but is most common in people between the ages of 10 and 30, according to the National Institutes of Health.

Typically, a patient arriving at the emergency room with suspected appendicitis undergoes a computed tomography (CT) and physical examination. If a radiologist is not immediately available to interpret the CT images or if consultation with a specialist is needed, the diagnosis is delayed, increasing the risk of rupture, said Choudhri. Transmitting the images over a mobile device allows for instant consultation and diagnosis from a remote location. It can also aid in surgical planning.

The researchers performed the study at the University of Virginia in Charlottesville. They looked at CT examinations by five radiologists of the abdomen and pelvis of 25 patients with pain in the right lower abdomen over an encrypted wireless network. Each radiologist used an iPhone G3 equipped with OsiriX Mobile medical image viewing software.

All of the patients had surgical confirmation or follow-up evaluations to confirm whether they had appendicitis.

"The scans can be read in full resolution with very little panning, and the software allows the reader to zoom and adjust the contrast and brightness of the image," Choudhri said. "The radiologist is evaluating actual raw image data, not snapshots."

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