While computed tomography (CT) remains the most accurate and widely used modality for appendicitis imaging, ultrasound has developed its own niche role, especially in the pediatric population and in premenopausal women. Ultrasound is commonly used as the initial imaging test when available, with indeterminate or clinically equivocal cases proceeding to CT. To avoid the radiation and time and cost of CT, ultrasound needs to be improved. While previous studies have focused on improving the diagnostic accuracy of ultrasound through better patient selection and technique, relatively little attention has been brought to the ultrasound report, which often serves as the sole mode of communication between the radiologist and the clinician. Standardization of reporting and terminology has been found to improve patient outcomes and management in breast imaging. A standardized report for appendicitis has the potential to decrease confusion and increase accuracy. A potential format could include a standardized list of the presence or absence of imaging findings associated with appendicitis, with a final summary or score indicating the likelihood of appendicitis being present. Aggregation of data over time through use of a common format could help guide radiologist recommendations based on which imaging findings are present. Overall, a standardized report could help increase the value of ultrasound, leading to improved radiologist-clinician communication, better patient outcomes, and decreased costs.
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