A Young Woman With Right Iliac Fossa Pain
For young patients with vague right iliac fossa pain and mild systemic signs, remember that localized tenderness alone is insufficient for definitive diagnosis. Using POCUS early can help rule out obvious pathology or guide the focus of your physical exam before ordering expensive imaging like CT. However, do not rely solely on ultrasound findings; a positive clinical suspicion warrants proceeding to cross-sectional imaging.
This case report details the evaluation of a young woman presenting with nonspecific right iliac fossa pain and low-grade fever, which is a common and often challenging presentation in the ED setting. Initial workup included physical exam findings suggesting localized tenderness without overt signs of peritonitis, alongside mild leukocytosis. The management pathway described utilized point-of-care ultrasound (POCUS) as an initial diagnostic adjunct before proceeding to definitive imaging with CT scan. This sequence highlights the utility of real-time ultrasound in guiding further investigation for acute abdominal pain when the clinical picture is equivocal. While POCUS was performed, the ultimate diagnosis required cross-sectional imaging, underscoring its role as a triage or supplementary tool rather than a standalone diagnostic determinant.