The Alvarado score (MANTRELS) is used in the diagnostic workup of suspected appendicitis. A score of 7 out of 10 in a 25-year-old man would be interpreted as:

• A Possible appendicitis — CT scan recommended before any surgical decision
• B Low probability — discharge with advice
• C Definitive appendicitis — proceed to theatre without further investigation
• D Probable appendicitis — surgical exploration indicated ✓

Explanation

The Alvarado (MANTRELS) score allocates points for Migration of pain to RIF (1), Anorexia (1), Nausea/vomiting (1), Tenderness in RIF (2), Rebound tenderness (1), Elevated temperature (1), Leucocytosis (2), Shift of WBC to left (1) — maximum 10 points. A score of 7–10 represents probable/definite appendicitis and is considered an indication for surgery (appendicectomy) in males. In females of childbearing age, gynaecological pathology must be excluded even at high scores. CT is recommended primarily for scores 4–6 (equivocal).

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.