Comparative role of Ultrasound and Computed Tomography in diagnosis of Nontraumatic Right iliac fossa pain in patients above 50 yr of age admitted in a tertiary-care hospital

USG vs CT in non-traumatic RIF pain in geriatrics

Abstract

                 Background: The most common cases in acute general surgical facilities are nontraumatic right iliac fossa (RIF) pain. There is a broad differential diagnosis, especially for older patients. In this population, computed tomography (CT) is frequently used.  Ultrasonography can be preferred as a first investigation in the acute onset of non-traumatic RIF pain.

               Aim: To assess the diagnostic accuracy variables of ultrasonography in diagnosing non-traumatic RIF pain in the elderly, taking computed tomography as the gold standard of investigation.

               Materials and methods: 50 patients in the elderly age group with non-traumatic RIF pain were evaluated consecutively by USG, followed by a CT scan.

               Results: Overall, in detecting non-traumatic RIF pain in our study, sonography was found to have sensitivity, specificity, PPV, and NPV of 35.14%, 23.07%, 56.52%, and 11.1% with respect to a CT scan. It also reveals that in diagnosing the different aetiologies of RIF pain, the findings of the USG have a weakly positive correlation with the findings of the CT scan. It also reveals that, on comparison between CT and USG, we found a statistically significant difference in diagnosing RIF pain in this study population.

               Conclusions: We therefore conclude that ultrasound may be used as an initial imaging investigation as the majority of cases of non-traumatic RIF pain come in the acute stage and emergency ultrasound comes into play due to its easy use and more availability. But we must do a CT scan after that to narrow down the differential diagnoses in this age group.