Appendicitis in children
Diagnostic accuracy studies and decision-support work on childhood appendicitis.
Research
Research that changes what happens at the bedside.
My research is clinical and practical: diagnostic accuracy in paediatric ultrasound, access to imaging for regional and First Nations families, patient safety, and the sonographer workforce. The full record is on ORCID, Google Scholar and PubMed.
Research themes
Renal and urological imaging
Ultrasound of the kidneys and urinary tract in children.
Regional access and equity
Education and support for regional sites, including communities with higher First Nations representation.
Imaging non-attendance
Why children do not attend booked imaging, and what can be done about it.
Neuroprotection protocols
Transcranial Doppler for children having cardiac surgery or ECMO.
Clinical audit
Audits that benchmark practice and lead to change.
Workforce and education
Work-integrated learning and sonographer training pathways.
Artificial intelligence
What AI means for sonographer competency and curriculum.
Case study: from evidence to practice
Inter-hospital transfers of children with abdominal pain
Ultrasound is often the first test for a child with acute abdominal pain, and in rural and regional Queensland it can shape the decision to transfer that child to a tertiary hospital. Transfers cost families time and money, and they cost the health system a good deal more. This work began as an evidence-gathering audit of those transfers, used to benchmark practice and target support, and it led to changes in how I support regional colleagues.
1. Evidence
2. Targeted action
3. Regional contact
4. Next: telehealth collaboration
The audit
The audit was an evidence-gathering exercise. We reviewed children transferred to a quaternary paediatric hospital for acute abdominal pain over a 12-month period, comparing imaging and diagnoses at the transferring site with those at the receiving hospital. The aim was to benchmark practice, identify where support was most needed, and target education and clinical support at those sites and conditions.
The findings pointed to where education and clinical support could reduce potentially unnecessary transfers. Because every child in the cohort had been transferred, the audit guides where support is needed and is not a measure of any individual service.
Reddan T, Halligan T, Corness J. An audit of inter-hospital transfers of children with abdominal pain and their associated medical imaging findings. Sonography. 2022;9:23–28. doi:10.1002/sono.12291
What changed as a result
Targeted education
Workshops and content for regional centres were shaped around the gaps the evidence identified. See the workshop and webinar table
An open line
At regional and rural meetings I now offer my contact details explicitly. Having met in person, colleagues are more likely to ask for help.
Contact from regional sites
Following workshops, there has been regular feedback sought about examination quality from colleagues in Darling Downs, Rockhampton, Hervey Bay, and the Sunshine Coast.
Where this is heading
The next phase builds on that contact. I am exploring how emerging telehealth platforms could make case collaboration contemporaneous for complex cases, support coaching and confidence-building for sonographers at smaller sites, and extend online workshops with live, case-based discussion. The aim is the same as the original audit: better local imaging decisions, and fewer transfers that were not needed.
Case study
Checking the brain's blood supply before heart surgery
The problem. Children who need heart surgery or extracorporeal membrane oxygenation (ECMO) often have a neck vessel cannulated or clamped, which can interrupt blood flow to the brain. If the Circle of Willis, the ring of arteries that shares flow around the brain, is incomplete, that interruption can cause ischaemia or stroke.
What we did. Since 2019 we have used duplex transcranial Doppler on a radiology-grade ultrasound system to survey the Circle of Willis at the bedside before surgery or cannulation. Manual carotid compression tests collateral flow where a segment looks absent or small, and the paper sets out the technique and its main pitfall, mistaking the anterior choroidal artery for a small posterior communicating artery. An incomplete circle lets the surgical team plan neuroprotection and adjust their approach before they begin.
What changed. The assessment became standard practice in 2022. Between July 2019 and June 2024, 720 children were screened with no major adverse events reported, and no catastrophic infarcts related to cervical cannulation have occurred since the protocol began. It needs no radiation and can be done at the bedside, where CT and MRI are harder to arrange.
Sources: Reddan T, Malouf M, Venugopal P, Powell J. J Med Radiat Sci 2025;73(Suppl 2):S109-S116. doi:10.1002/jmrs.845. Screening numbers from the CHQ Research Impact Report 2024 (p. 8).
Selected publications
- Ryan E, Norynberg K, Connor P, Sinclair D, Reddan T. From evidence to practice: implementation and evaluation of the discontinuation of patient contact shielding in paediatric radiography. J Med Radiat Sci 2025;73(Suppl 2):S101-S108. doi:10.1002/jmrs.70053 Featured in the CHQ Research Impact Report 2025 (p. 12).
- Cleary et al. Benchmarking non-attendance patterns in paediatric medical imaging: a retrospective cohort study spotlighting First Nations children. Radiography 2024. doi:10.1016/j.radi.2024.01.002
- Reddan T, Corness J, Harden F, Mengersen K. Improving the value of ultrasound in children with suspected appendicitis: a prospective study integrating secondary sonographic signs. Ultrasonography 2018;38(1):67-75. doi:10.14366/usg.17062
- Reddan T, Malouf M, Venugopal P, Powell J. Pre-operative transcranial Doppler ultrasound assessment of cerebral collateral circulation in children undergoing veno-arterial extracorporeal membrane oxygenation or cardiac surgery. J Med Radiat Sci 2025;73(Suppl 2):S109-S116. doi:10.1002/jmrs.845 Featured in the CHQ Research Impact Report 2024 (p. 8).