A plain film of the abdomen and pelvis should be performed first to survey the patient and potentially identify other causes of RLQ pain. If appendicitis remains an important differential consideration the next step is a CT scan of the abdomen and pelvis with oral contrast and "appendix" protocol. This will target the appendix but also survey the entire abdomen and pelvis. US of the appendix is relatively ineffective compared to CT. Occasionally a female child may receive a pelvic US before CT to screen for a potential right adnexal mass that is presenting in a manner similar to appendicitis. BE, MRI, and NM bleeding or Meckels scanning are not routinely employed.