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Alvarado score: appendicitis

Hepatology & GI

Structures the clinical probability before imaging. Good at ruling out (<4) and less good at ruling in: imaging still decides in most adults.

What you enter

  • Migration of pain to the right iliac fossa (+1)
  • Anorexia (+1)
  • Nausea / vomiting (+1)
  • Tenderness in the right iliac fossa (+2)
  • Rebound tenderness (+1)
  • Temperature >37.3 °C (+1)
  • Leukocytosis >10 ×10⁹/L (+2)
  • Neutrophil left shift (>75%) (+1)
FORMULAMANTRELS: Migration 1, Anorexia 1, Nausea 1, Tenderness RIF 2, Rebound 1, Elevated temperature 1, Leukocytosis 2, Shift 1
SourceAlvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986;15:557-64ReviewedFormula and thresholds checked against the source on 2026-08-22. If the source updates, this line will say so.