POCUS for appendicitis is a powerful tool—especially in younger adults and paediatric patients. Finding the appendix can be tricky, as it can lie in multiple locations. Approach 1: Look where it hurts This is the fastest and most intuitive method. 🔎 Probe choice: • Linear probe for thin patients • Curvilinear probe if deeper penetration is required 🧠 Technique: • Place the probe over the point of maximal tenderness • Scan in both transverse and longitudinal planes ✅ Positive findings: • Blind-ended tubular structure • Diameter >6 mm • Non-compressible • Absent peristalsis 💡 Pro tip: Use graded compression to displace bowel gas and bring the appendix into view. 💡 Pro tip 2: Apply colour doppler to look for Ring of fire

A quick scan of the right lower quadrant reveals: • A dilated, blind-ending tubular structure • Non-compressible, no peristalsis • Diameter >6 mm • Surrounding echogenic fat stranding • Multiple echogenic foci with posterior acoustic shadowing There is also localised free fluid and free air, highly suggestive of ruptured appendicitis with appendicolith. The patient is referred back to surgery. A CT scan is ordered and confirms perforated appendicitis. Patient is taken to theatre which confirms appendicitis with pus in RLQ. 🤖📟 Case closed.

What a brilliant few days as faculty at #LACE advanced echo course in #LEEDS! 🤩 Hands-on scanning for delegates was a huge hit. The talks, including cases & echo with LVADs, were superb. Met some amazing faculty and passionate echo enthusiasts – the future of advanced echo is bright! If you're keen, one to look out for next year! #echofirst #criticalcare On to #TOE toemorrow ! @MaxRidley3 @Manoj_Wickram