El-Gohary Y, Molina M, Chang J, et al. - Researchers sought to compare the work-up of suspected appendicitis between a children’s hospital in the United States (USA) and one in Spain to determine disparities in imaging use and linked outcomes. Evaluation of a total of 1,952 children was included. Among the 1,288 children in the USA center, computed tomography (CT) was performed on 754 (58.5%) during their evaluation. Ultrasound (US) only was the most common imaging modality (39.9%), followed by CT only (39.3%), CT + US (19.3%), and no imaging (ie, only clinical acumen) (1.6%). In Spain, CT was performed on only 19 (2.9%) of 664 children. Only clinical acumen was the most common modality employed (48.6%), followed by US only (48.5%), US + CT (2.4%), and CT only (0.5%). Similar clinical outcomes and similar accuracy rates were observed using clinical acumen and/or US relative to heavy reliance on CT imaging for diagnosing appendicitis, with correlated reduction in radiation exposure. The two centers exhibited great differences in diagnostic approach possibly reflecting that physical examination is a dying art in North America.