⚕️ For clinical reference only. Not a substitute for professional judgment.

Alvarado Score Appendicitis

10-point score for acute appendicitis probability. Guides CT/USS imaging and surgical referral decisions in adults.

0/10

Low Probability

Select criteria present.

Symptoms (S)

Migration of pain to RIF+1 Nausea+1 Vomiting+1

Signs (S)

RIF tenderness+2 Rebound tenderness+1 Elevated temperature (>37.3°C / 99.1°F)+1

Labs (L)

Leukocytosis (>10 ×10⁹/L)+2 Left shift (neutrophilia >75%)+1

Management Guide

1–3 = Low (~10%) → Discharge + return advice
4–6 = Equivocal (~33%) → CT abdomen/pelvis; 4h obs
7–9 = High (~70%) → Surgical review; CT to confirm
10 = Almost certain → Theatre prep

References

Alvarado A. Ann Emerg Med. 1986.
NICE — Appendicitis (acute): recognition and management. 2021.