Modified Alvarado score for diagnosis of appendicitis

Feature	Points
Migratory right lower quadrant pain	1
Anorexia	1
Nausea or vomiting	1
Tenderness in the right lower quadrant	2
Rebound tenderness in the right lower quadrant	1
Fever >37.5°C (>99.5°F)	1
Leukocytosis of white blood cell count >10 × 10⁹/liter	2
Total	9

Score of 0 to 3 indicates appendicitis is unlikely and other diagnoses should be pursued. Score of ≥4 indicates that the patient should be further evaluated for appendicitis.

C: centigrade; F: Fahrenheit.

Modified from: Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986; 15:557.

Graphic 111766 Version 2.0

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