Imaging of Right Lower Quadrant Pain in Children and Adolescents: AJR Expert Panel Narrative Review

Sarah M. Desoky, Michael George, Monica Epelman, Donald P. Frush, David M. Gourlay, Michael M. Moore, Gary R. Schooler, Alexander J. Towbin, Unni Udayasankar, Melissa Zukowski, Michael J. Callahan

Research output: Contribution to journalArticlepeer-review


Right lower quadrant (RLQ) pain is a common clinical presentation in children, and accurate clinical diagnosis remains challenging given that this nonspecific presentation is associated with numerous surgical and nonsurgical conditions. The broad differential diagnosis varies by patient age and sex. Important considerations in the selection of a diagnostic imaging strategy include the sequencing, performance, and cost of tests. This article provides a comprehensive narrative review of the diagnostic imaging of RLQ pain in children and adolescents, including a discussion of the complementary roles of ultrasound, CT, and MRI; description of key imaging findings based on available evidence; and presentation of salient differential diagnoses. Subspecialized pediatric emergency medicine and surgical perspectives are also provided as further clinical insight into this common, but often challenging, scenario. Finally, the current status of imaging of RLQ pain in children and adolescents is summarized on the basis of expert consensus.

Original languageEnglish (US)
Pages (from-to)767-779
Number of pages13
JournalAmerican Journal of Roentgenology
Issue number6
StatePublished - Jun 2023
Externally publishedYes


  • acute appendicitis
  • ovarian torsion
  • pediatric abdominal imaging
  • pediatric abdominal pain
  • pediatric right lower quadrant pain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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