Ultrasound vs CT for Diagnosing Acute Appendicitis and Appendicitis Treatment Altering Conditions

Interested in imaging modalities and their effectiveness in diagnostics?  Read the abstract and click the link below for our newest accepted publication!


Ultrasound vs CT for Diagnosing Acute Appendicitis and Appendicitis Treatment Altering Conditions

Christopher Borowy, MS-IV1*, Luke Rond, D.O2, John Ashurst, D.O2, and Stefan Merrill, M.D2
1Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
2Department of Emergency Medicine, Kingman Regional Medical Center, Kingman, AZ, USA

Introduction: Acute appendicitis is the most common cause of atraumatic abdominal pain in children over 1 year of age. Even though diagnostic imaging modalities have evolved over the past 20 years, accurate diagnosis of acute appendicitis still presents as a challenge. Computed tomography (CT) is currently the most commonly used radiographic test for acute appendicitis. Unlike CT, ultrasound (US) does not require ionizing radiation which is harmful to the patient. Even though the specificity of US has been well studied in acute appendicitis, CT is still commonly requested after a positive US. Till date, there has been no published research evaluating the utility of US in changing management in appendicitis.

Purpose: The purpose of the study is to compare the ability of US and CT to diagnose pathology proven acute appendicitis and to predict Appendicitis Treatment Altering Conditions (ATAC).

Methods: This is a retrospective cohort study that compares the positive predictive value (PPV) and the ATAC rate of US and CT when diagnosing acute appendicitis.

Results: There were 432 appendicitis cases reported between 1 October 2012 and 30 June 2017. Of those cases, 409 were diagnosed by CT and 23 were diagnosed by US. The PPV of both modalities was above 90% (CT = 97%, US = 95%), and the ATAC rates were statistically similar (CT = 14%, US = 22%, P = 0.21).

Conclusion: The study supports that a positive US for appendicitis is as diagnostic as a positive CT. Therefore, adding on a CT scan after a positive US does not help recognize other sources of intra-abdominal pathology that would negate doing a laparoscopy.

Keywords: US, ultrasound, CT, CAT, ATAC, appendicitis, sensitivity, positive predictive value, PPV


Transfemoral Aortic Valve-in-Valve Replacement in Patient with Aortic Root Pseudoaneurysm

Another new and interesting article from our Fall 2019 Issue!  Read the abstract below and click on the link for the full article.

Transfemoral Aortic Valve-in-Valve Replacement in Patient with Aortic Root Pseudoaneurysm (Click link for full PDF)


Authors: Mark A. Nolan, P.E., M.Eng1, Stephane Leung Wai Sang, M.D., MSc2

Background: Transcatheter aortic valve replacement (TAVR) was successfully performed to treat aortic regurgitation (AR) in a patient with a failed aortic valve replacement complicated by aortic root pseudoaneurysm.

Case Presentation: A 92-year-old male presented with acute decompensated congestive heart failure secondary to AR of a previously implanted stentless aortic bioprosthesis, complicated by a 2.5 x 1.7 cm pseudoaneurysm of the aortic root.

Conclusions: Complex aortic root and valve disease can be safely and effectively addressed through the use of TAVR in high-risk patients. The presence of a pseudoaneurysm should not preclude successful TAVR.


Association between Total Knee Arthroplasty and Subtalar Joint Changes: A Cadaver Study

New article from the MSRJ 2019 Fall issue is now up on the site! Read the abstract or click on the link below for the full article.

Association between Total Knee Arthroplasty and Subtalar Joint Changes: A Cadaver Study (Click link for full PDF article)

Authors: Dominick J. Casciato, B.A.1*, Natalie A. Builes, B.A.2, Luis A. Rodriguez Anaya, DPM1, Bibi N. Singh, DPM1

Background: Total knee arthroplasty (TKA) has become the procedure of choice for those suffering from debilitating degenerative joint disease of the knee; however, new research suggests that functional changes in the rearfoot occur following the procedure to compensate for gait changes. This pilot study investigates subtalar joint (STJ) changes in cadavers with TKAs.

Methods: Four embalmed cadavers with a unilateral TKA were disarticulated at the STJ and the calcaneal articular facets were imaged. The length, width, and area of these facets ipsilateral to the joint replacement were measured using image analysis software and compared to the contralateral side.
Results: All cadavers exhibited evidence of anatomical changes at the STJ. Moreover, a transition to an anatomically unstable STJ was observed.

Conclusions: This study suggests that biomechanical compensation at the STJ may result in anatomical changes in the joint in which form of the joint follows function. Though this pathology may have developed prior to such arthroplasty, the unilateral nature of the facet changes emphasizes the need to further investigate and address gait abnormalities before and after joint replacement to optimize biomechanics in the arthritic knee.




Volume 7: Spring 2019 Issue

MSRJ Vol. 7 Spring 2019

The Spring 2019 issue is hot off the press! Click on the cover art to view and share the full issue!

Thank you to our artist, authors, student and faculty reviewers, and our E-Board for all your hard work and dedication to advancing evidence-based medicine!

Interested in a print copy? email us at @: contact@msrj.org

MSRJ 2019 Cover Art Competition

The Medical Student Research Journal is hosting its first cover art competition! This is a competition to have your art featured in the Fall 2019 edition of the Medical Student Research Journal. This is a great opportunity to showcase humanism in medicine and earn a CITATION that you can add to your curriculum vitae!


• Competition Dates?  June 1 to August 31, 2019
• Theme?  Medicine
• Who is eligible?  All MSU graduate and undergraduate students, KCAD students.
• How to compete? Please submit artwork in PDF or JPEG format by 11:59pm, August 31 2019.

Please send submissions to:

Check out the official flyer and last years cover art below:

Fall 2018 publication cover

Equator Manuscript Reporting Guidelines

Hello authors,

We at MSRJ are working hard to streamline the manuscript review process to reduce the time between submission date and when a decision is made on final publication.   One of the numerous barriers to fast and efficient manuscript review is something that is under author control – the quality of the submitted manuscript.   In this post, I will describe an indispensable tool all authors should use in preparing a manuscript for publication.

The resource I am referring to is the “Reporting Guideline”.  A reporting guideline is a document that outlines the minimum required content for your manuscript.  It is like a checklist of what information should be included in your manuscript. The purpose of a guideline is to ensure authors provide required information such that a reader knows exactly what you did in your study, and if so desired, they could repeat your study using only your manuscript as a guide. The goal is to ensure all published research papers have proper reporting of details to ensure they can be critically appraised, utilized in systematic reviews, or repeated.

Use of a reporting guideline when writing your manuscript will also help shorten the time it takes from manuscript submission to journal decision.  One of the major delays in the review process occurs when submitted manuscripts have missing information.   This requires the journal to request a resubmission of the manuscript with the missing information, often requiring a second review.  To avoid such a needless delay, we strongly recommend using a reporting guideline when submitting a manuscript to MSRJ.


So what should MSRJ authors do?

(1) Go to The Equator Network website (http://www.equator-network.org/). The Equator Network hosts hundreds of reporting guidelines on many different study design types.  There are reporting guidelines for randomized trials, observational studies, systematic reviews, qualitative research, and case reports, among many others.

(2) On the Equator Network website, find the guideline appropriate to your study type.

(3) Once you have found the appropriate guideline, use the associated checklists to ensure you report all required information.

(4) Finally, cite the guideline you used in your manuscript.

By utilizing the appropriate guideline and adhering to its recommendations, you will ensure a smooth initial review and help improve the quality of research reporting in general.


Mark Trottier, Ph.D.

MSRJ Faculty Advisor

New Feature: MSRJ e-Publications

epub early access picture

MSRJ’s Exciting New Feature!

The staff of MSRJ is extremely pleased to announce the addition of an exciting new feature to our journal! Starting today, we will be launching MSRJ e-Publication, which will be our first ever early-access publication issue. MSRJ e-publication will enable us to publish articles “online before print” as many other journals do. This new feature has many advantages for our student contributors including:

  • Faster publishing time for accepted manuscripts
  • Increased ease of access
  • Greater longevity of published literature
  • Assignment of a unique Digital Object Identifier number

We want to express our appreciation and thanks to the authors who have been instrumental in getting this put together. We invite you to take a look at their articles in our first-ever e-Pub Early Access Issue:


Combating Obstacles to Empathy: A Replicable Small Group Discussion Series for Medical Students.

Authors: Francesca P. Kingery, M.S., Alexander Bajorek, M.D. M.A., Amber Zimmer Deptola, M.D. Karen Hughes Miller, Ph.D., Craig Ziegler Ph.D., Pradip D. Patel M.D.

Medals4Mettle: A Program to Enhance the Medical Student-Patient Bond

Authors: McKenzie Vater MS3, Pradip D. Patel MD, Kanyalakshmi Ayyanar, MD, Autumn Marks, RN BSN CPHON, Craig Ziegler, PhD, Karen Hughes Miller,PhD

Does Traditional Chinese Medicine Matter? Medical Choices of Rural Diabetic Patients in Changsha, China.

Authors: Xiaoyue Mona Guo, B.A., Shuiyuan Xiao, M.D., Ph.D.

Time to Neurological Deterioration in Ischemic Stroke.

Authors: James E. Siegler, MD; Karen C. Albright, DO, MPH; Alexander J. George, BS; Amelia K. Boehme, MSPH; Michael A. Gillette, MPH; Andre D. Kumar, MD; Monica Aswani MSPH; Sheryl Martin-Schild, MD, PhD


What is e-Publication?

With MSRJ ePubs, not only will student authors be able to see their manuscripts published earlier, but each article will be assigned an individual Digital Object Identifier (DOI) number. A DOI number is a unique alphanumeric string assigned to a digital object. The DOI number is then registered with CrossRef.org, which is an official DOI registration agency dedicated to providing reliable and efficient reference linking for online scholarly material.

Each DOI uniquely identifies the article and provides a permanent link that takes readers to that particular electronic document, even if the web address which originally hosted the article changes.

These DOI’s already exist in various online journals such as JAMA and NEJM. They also provide ease of citation since they provide a short, easy, and unchanging link to the original document as opposed to a lengthy web address.


What Does This Mean for Student Contributors?

The use of DOIs enables us to safely publish intellectual property on the internet, prior to print, and without fear of plagiarism. The fact that DOIs are registered with Crossref © makes them permanent, so our student authors will always be able to find their articles, even many years down the road, using just that unique identifier. Finally, it makes these articles easy to reference, for any future researchers.

At any point in the future, people can access an article just by typing doi.org/ followed by the DOI number. This will automatically take you to wherever the article is housed at that time. It’s that simple!

Starting from today onwards, accepted manuscripts which have been prepared for e-Publication will be available for viewing under the new tab “ePubs” under “Publications” on the MSRJ website. Once we are off the ground, our MSRJ Tech Team will continue to work with the Executive Editors to format and prepare accepted manuscripts for e-Publication, and will continue fine-tuning the process to ensure smooth and continuous e-Publishing.


Behind the Scenes Work:

We would like to extend a special thanks our wonderful MSRJ Tech Team for their endless energy and tireless work towards getting e-Publication launched and helping our journal continue to grow. This has been no small feat, and we could not have done it without them! Leading the charge are Danny Yau and Danielle Levy, second-year medical students at MSU-CHM. They have been instrumental in designing the MSRJ template for our e-Publications, getting the MSRJ set up to accept and publish e-Publications, andestablishing the procedure for assigning DOIs to our manuscripts for future online publication.

We would also like to thank our faculty advisors, Dr. Luz and Dr. Trottier, for their support in helping us coordinate this transition to e-Publication.


Final Words:

As the longest-running journal run by medical students for medical students, we at the MSRJ strive to provide the highest quality product and experience for our student contributors. We hope that the addition of e-Publication will provide medical students another platform to promote their scholarship and research. and would like to thank our authors for their great submissions, support, and patience as we transition into this new phase.

MSRJ Elective Update: Academic Medicine

On Wednesday, February 10, Dr. Rajil Karnani came to the East Lansing campus to talk to the students in the MSRJ Elective about careers in academic medicine. He presented about the many ways to become involved in academia, and the variety of career pathways that academic medicine can offer.  He covered the advantages and disadvantages to consider, along with the keys to success that he has learned over the years. Dr. Karnani also gave some personal anecdotes on his experience and some tricks of the trade that he wished he knew when he entered the field. Lastly, Dr. Karnani fielded questions from the 30 students who attended the lecture. The students enjoyed the lecture and found it very informative, as careers in academic medicine are seldom talked about during our learning and training.


Student question and answer session with Dr. Rajil Karnani

Student question and answer session with Dr. Rajil Karnani.


Dr. Rajil Karnani lectures to the MSRJ Elective students about pursuing a career in academic medicine.

Dr. Rajil Karnani lectures to the MSRJ Elective students about pursuing a career in academic medicine.