Comparison of Diagnostic Accuracy of CT scan and USG in Right Upper Quadrant Pain: A Review Analysis

Abstract

Purpose: Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. The main objective of the study is to systematically analyse the comparison of diagnostic accuracy of ultrasound and computed tomography in right upper quadrant pain. Material and methods: This study was conducted using a systematic search on Google scholar, Pubmed and Web of science published until 20th June 2020. The cited references of retrieved articles and previous reviews were also manually checked to identify any additional eligible studies with indexed search terms for cholecystitis, US, cholescintigraphy, CT, and MR imaging. Results: After excluding duplicates and articles that did not meet the inclusion criteria, we obtained 30 articles with full-texts which were read for further evaluation, where another 60 were excluded as irrelevant. Overall, we included 30 articles that directly match on the inclusion criteria. Conclusion: It is concluded that RUQ pain were not as good as sensitivities reported in prior studies. CT was statistically significantly better for the diagnosis of RUQ pain than US, most likely because of an unclear clinical picture, the patient population, and a high proportion of poor-quality US examinations. However, US is still our first test of choice if RUQ pain is suspected clinically, whereas CT is performed when the clinical picture is unclear.