Related Experiment Video
Updated: Feb 22, 2026
Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
US Emergency Department Trends in Imaging for Pediatric Nontraumatic Abdominal Pain
Lauren M Niles1, Monika K Goyal2,3, Gia M Badolato3
1Milken Institute School of Public Health and.
Insights
Computed tomography (CT) and ultrasound use for pediatric nontraumatic abdominal pain in emergency departments (EDs) remained stable from 2007-2014. General EDs showed higher CT use, while pediatric EDs favored ultrasound.
Area of Science:
- Pediatric Emergency Medicine
- Radiology Trends
- Abdominal Imaging
Background:
- Nontraumatic abdominal pain is a common reason for pediatric emergency department visits.
- Imaging modalities like computed tomography (CT) and ultrasound are frequently used for diagnosis.
- Understanding trends in imaging use is crucial for optimizing patient care and radiation exposure.
Purpose of the Study:
- To analyze national trends in the utilization of CT and ultrasound for pediatric nontraumatic abdominal pain evaluations.
- To compare imaging practices between pediatric emergency departments (PEDs) and general emergency departments (GEDs).
Main Methods:
- Utilized data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) between 2007 and 2014.
- Examined trends in CT and ultrasound use for children presenting with nontraumatic abdominal pain.
- Employed multivariable logistic regression to assess the association between ED type and imaging modality selection, controlling for confounders.
Main Results:
- CT and ultrasound use for pediatric nontraumatic abdominal pain showed no significant change from 2007-2014.
- CT imaging was less common in pediatric EDs compared to general EDs (adjusted odds ratio 0.34).
- Ultrasound imaging was more prevalent in pediatric EDs than in general EDs (adjusted odds ratio 2.14).
Conclusions:
- CT imaging for pediatric nontraumatic abdominal pain has plateaued since 2007.
- General EDs are more likely to utilize CT, whereas pediatric EDs favor ultrasound for these cases.
- Disseminating pediatric-specific radiology protocols to general EDs could optimize radiation exposure in children.
Objectives:
To describe national emergency department (ED) trends in computed tomography (CT) and ultrasound imaging for the evaluation of pediatric nontraumatic abdominal pain from 2007 through 2014.
Methods:
We used data from the National Hospital Ambulatory Medical Care Survey to measure trends in CT and ultrasound use among children with nontraumatic abdominal pain. We performed multivariable logistic regression to measure the strength of the association of ED type (pediatric versus general ED) with CT and ultrasound use adjusting for potential confounding variables.
Results:
Of an estimated 21.1 million ED visits for nontraumatic abdominal pain, 14.6% (95% confidence interval [CI], 13.2%-16.0%) had CT imaging only, 10.9% (95% CI, 9.7%-12.1%) had ultrasound imaging only, and 1.9% (95% CI, 1.4%-2.4%) received both CT and ultrasound. The overall use of CT and ultrasound did not significantly change over the study period (P trend .63 and .90, respectively). CT use was lower among children treated in pediatric EDs compared with general EDs (adjusted odds ratio 0.34; 95% CI, 0.17-0.69). Conversely, ultrasound use was higher among children treated in pediatric EDs compared with general EDs (adjusted odds ratio 2.14; 95% CI, 1.29-3.55).
Conclusions:
CT imaging for pediatric patients with nontraumatic abdominal pain has plateaued since 2007 after the steady increase seen in the preceding 9 years. Among this population, an increased likelihood of CT imaging was demonstrated in general EDs compared with pediatric EDs, in which there was a higher likelihood of ultrasound imaging. Dissemination of pediatric-focused radiology protocols to general EDs may help optimize radiation exposure in children.
More Related Videos
05:50Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
07:12Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Related Concept Videos
01:27Imaging Studies III: Computed Tomography
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies
01:24Imaging Studies II: Ultrasonography
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...