Emergency Diagnostic Radiology

By Dr.Xiu

Alvarado Score for Acute Appendicitis

The Alvarado score is a clinical scoring system used in the diagnosis of appendicitis. The score has 6 clinical items and 2 laboratory measurements with a total 10 points.


A score of 5 or 6 is compatible with the diagnosis of acute appendicitis. A score of 7 or 8 indicates a probable appendicitis, and a score of 9 or 10 indicates a very probable acute appendicitis.

A popular mnemonic used to remember the Alvarado score factors is MANTRELS
Migration to the right iliac fossa
Anorexia, Nausea/Vomiting
Tenderness in the right iliac fossa
Rebound pain
Elevated temperature (fever)
Shift of leukocytes to the left

Due to the popularity of this mnemonic, the Alvarado score is sometimes referred to as the MANTRELS score.

Here is some recommended guideline.


Reference: ER Notebook, The royal college of surgeons of Edinburgh, Wikipedia


Filed under: Acute Appendicitis, Gastrointestinal Emergency, , ,

One Response

  1. Santosh Timalsina says:

    When do you say it’s shift to left?

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