Alvarado Score

Clinical prediction score for acute appendicitis, combining symptoms, signs, and basic labs (MANTRELS).

For healthcare professionals.These calculate a score or a measurement from values you enter. They do not diagnose, and they are no substitute for clinical judgement. If you are a patient, discuss any result with your own doctor rather than acting on it.

Migration of pain to right lower quadrant

Anorexia

Nausea or vomiting

Tenderness in right lower quadrant (+2)

Rebound tenderness

Elevated temperature (> 37.3°C / 99.1°F)

Leukocytosis (WBC > 10,000/µL) (+2)

Left shift (neutrophils > 75%)

Result

0 / 10

Low probability

Low probability. Appendicitis unlikely — consider alternative diagnoses; imaging generally not required on this basis alone.

Do not use when

Less sensitive in children, pregnant patients, and the elderly. Falling sensitivity has been reported in some non-Western populations — the RIPASA score is sometimes preferred there.

Source

Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557-564.

Shown for reference and checked against the source above. Confirm against current guidance before acting on it, and use your own clinical judgement.

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