Appendicitis other diagnostic studies

Appendicitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Appendicitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Diagnostic Scoring
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Appendicitis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Appendicitis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Appendicitis
CDC on Appendicitis
Appendicitis in the news
Blogs on Appendicitis
Directions to Hospitals Treating Appendicitis
Risk calculators and risk factors for Appendicitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The Alvarado score is the most widely used scoring based system in making a diagnosis of appendicitis.

Alvarado score

A number of clinical and laboratory based scoring systems have been devised to assist the diagnosis of appendicitis. The most widely used is the Alvarado score:

Symptoms:

• Migratory right iliac fossa pain - 1 point
• Anorexia - 1 point
• Nausea and vomiting - 1 point

Signs:

• Right iliac fossa tenderness - 2 points
• Rebound tenderness - 1 point
• Fever - 1 point

Laboratory:

• Leucocytosis - 2 points
• Shift to left (segmented neutrophils) - 1 point

Total score = 10.

A score of 7 or more is strongly predictive of acute appendicitis.
In patients with an equivocal score of 5-6, CT scan further reduces the rate of negative appendectomy.