Alvarado Score for Appendicitis
Probability of acute appendicitis from history, examination and white cell count, scored 0–10.
When to use it. Assessing right iliac fossa pain in an adult.
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0of 10
Appendicitis unlikely
Low probability. Consider discharge with safety-netting and a clear plan to return.
1 point each except right-iliac-fossa tenderness and leukocytosis, which score 2 (total 0–10).
Limits of this score. Alvarado performs poorly in women of reproductive age, where gynaecological causes mimic it, and in children and older adults. A low score does not exclude appendicitis and a high score is not consent for surgery — it is a triage tool for who needs imaging.
Sources
- Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986;15:557–64.
Where this is written from. This site is written from Indian clinical practice. Drug availability and brand names, vaccination schedules, national health programmes and some reference cut-offs differ between countries — a schedule or a threshold that is standard here may not be standard where you are. If you are reading outside India, check anything on this page against your own country’s guidance before you act on it.
Educational use only — not medical advice. Never a substitute for clinical judgement.