Right Lower Quadrant Pain in a Young Female: Ultrasound Diagnosis of Rectus Abdominis Tear.
BACKGROUND
Right lower quadrant pain in young females presents a frequent diagnostic challenge for emergency physicians, with a broad differential and several important diagnoses. Using an "ultrasound first" imaging strategy can help decrease the use of computed tomography scans, with associated savings in radiation exposure, cost, and other resource use.


METHODS
We report a case of right lower quadrant pain in a young woman. After her initial history and physical examination, appendicitis was the leading differential. A bedside ultrasound was performed, leading to the uncommon diagnosis of rectus abdominis muscle tear. The sonographic findings of a muscle tear include increase in size, loss of linear, homogeneous architecture, and decreased echogenicity. Making this diagnosis at the bedside using ultrasound obviated the need for further imaging, avoiding unnecessary radiation exposure, and decreasing emergency department length of stay and overall cost, while leading to a tailored treatment plan. Why Should an Emergency Physician Be Aware of This? Rectus abdominis tear is a cause of right lower quadrant pain that may mimic appendicitis and should be considered in patients with this complaint. The ability to make this diagnosis with bedside ultrasound may assist in several important patient-oriented outcomes.
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia.
Joseph
J
Minardi
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia.
Erica
E
Shaver
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia.
Aaron
A
Monseau
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia.
Adam
A
Pratt
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia.
Shelley M
SM
Layman
D015746:Abdominal Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D019095:Point-of-Care Systems; D017568:Rectus Abdominis / Q000000981:diagnostic imaging* / Q000293:injuries*; D012421:Rupture / Q000150:complications / Q000000981:diagnostic imaging; D014463:Ultrasonography; D055815:Young Adult
muscle tear; rectus abdominis; right lower quadrant pain; ultrasound