Abstract
Acute right lower quadrant pain is a common emergency department presentation. Medical imaging has a main role to rule out appendicitis. Distinguishing between appendicitis and the other two major appendix pathologies, mucocele and carcinoid tumors, is not easy, but it is important for medical and surgical management planning. Appendix mobility is not usually assessed during sonography, but is it helpful? When comparing sonography and computerized tomography with histopathology findings to distinguish appendiceal pathologies, appendix mobility was found to be a key component. Appendix diameter, wall thickness, hyperemia, and surrounding echogenic fat are signs of an inflammatory process that will fix the appendix. Appendiceal carcinoids and mucoceles, on the other hand, will not initially have an inflammatory component for years, and thus patients present with only mild recurrent vague abdominal pain, normal blood work, and mild or borderline imaging findings. Sonography should be the first-choice medical imaging modality to rule out appendiceal pathologies because appendix mobility should be assessed and reported.