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Correction to Paulson et al., N Engl J Med 348(3):236-242 January 16, 2003.

Correspondence
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Volume 349:305-306 July 17, 2003 Number 3
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Suspected Appendicitis

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by Paulson, E. K.
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To the Editor: Paulson et al. (Jan. 16 issue)1 propose an algorithmic approach to the evaluation of right-lower-quadrant pain. The approach to the evaluation of suspected appendicitis has changed with technology. Although the history and the physical examination remain paramount, imaging studies, including computed tomography and ultrasonography, have an increasingly important role in cases of equivocal presentation. However, there is concern that the algorithmic approach may be skewed toward equivocal presentation, given evidence that the physical-examination skills of U.S. medical graduates in evaluating possible appendicitis are deficient. One study showed that only 5 of 113 examinees (4 percent) correctly elicited . . . [Full Text of this Article]



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