🩹 Alvarado Score (Appendicitis)
Estimate the likelihood of acute appendicitis with the Alvarado (MANTRELS) score.
Less reliable in women and children.
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When to use
Support decisions on imaging, observation or surgical referral in suspected appendicitis.
How it works
Migration 1, anorexia 1, nausea/vomiting 1, RLQ tenderness 2, rebound 1, fever 1, leukocytosis 2, left shift 1. ≤4 unlikely, 5–6 compatible, ≥7 probable.
Key points
- Less reliable in women and children.
- Intermediate scores usually warrant imaging.
- Not a substitute for surgical assessment.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Migration of pain to RLQ | No |
|---|---|
| Anorexia | No |
| Nausea/vomiting | No |
| Tenderness in RLQ | No |
| Rebound tenderness | No |
| Elevated temperature ≥ 37.3°C | No |
| Leukocytosis > 10 ×10⁹/L | No |
| Left shift (neutrophilia > 75%) | No |
→Alvarado0/10
- Interpretation：Appendicitis unlikely
| Migration of pain to RLQ | Yes (+1) |
|---|---|
| Anorexia | Yes (+1) |
| Nausea/vomiting | Yes (+1) |
| Tenderness in RLQ | Yes (+2) |
| Rebound tenderness | Yes (+1) |
| Elevated temperature ≥ 37.3°C | Yes (+1) |
| Leukocytosis > 10 ×10⁹/L | Yes (+2) |
| Left shift (neutrophilia > 75%) | Yes (+1) |
→Alvarado10/10
- Interpretation：Probable appendicitis — surgical review
Frequently asked questions
- What is Alvarado Score (Appendicitis)?
- Estimate the likelihood of acute appendicitis with the Alvarado (MANTRELS) score.
- How is Alvarado Score (Appendicitis) calculated? What is the core formula?
- Migration 1, anorexia 1, nausea/vomiting 1, RLQ tenderness 2, rebound 1, fever 1, leukocytosis 2, left shift 1. ≤4 unlikely, 5–6 compatible, ≥7 probable.
- When is Alvarado Score (Appendicitis) used?
- Support decisions on imaging, observation or surgical referral in suspected appendicitis.
- What are the key clinical points for Alvarado Score (Appendicitis)?
- Less reliable in women and children. Intermediate scores usually warrant imaging. Not a substitute for surgical assessment.
- What are the limits and cautions when using Alvarado Score (Appendicitis)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Alvarado Score (Appendicitis) calculated in practice? Can you show a worked example?
- Inputs: Migration of pain to RLQ No, Anorexia No, Nausea/vomiting No, Tenderness in RLQ No, Rebound tenderness No, Elevated temperature ≥ 37.3°C No, Leukocytosis > 10 ×10⁹/L No, Left shift (neutrophilia > 75%) No → Result: Alvarado 0 /10（Interpretation: Appendicitis unlikely） Inputs: Migration of pain to RLQ Yes (+1), Anorexia Yes (+1), Nausea/vomiting Yes (+1), Tenderness in RLQ Yes (+2), Rebound tenderness Yes (+1), Elevated temperature ≥ 37.3°C Yes (+1), Leukocytosis > 10 ×10⁹/L Yes (+2), Left shift (neutrophilia > 75%) Yes (+1) → Result: Alvarado 10 /10（Interpretation: Probable appendicitis — surgical review）