The Alvarado Score is a clinical decision-making tool designed to evaluate the probability of acute appendicitis in patients presenting with abdominal pain. Developed in 1986 by Dr. Alfredo Alvarado, the score integrates common symptoms, physical examination findings, and simple laboratory tests into a 10-point system. Its purpose is to improve diagnostic accuracy, reduce unnecessary surgeries, and guide decisions regarding imaging or observation.

The components of the score include migratory right iliac fossa pain, anorexia, nausea or vomiting, tenderness in the right lower quadrant, rebound tenderness, elevated temperature, leukocytosis, and neutrophilia. Each parameter is weighted, with certain clinical findings like tenderness in the right iliac fossa carrying higher point values.

A total score of 7 or more is generally considered strongly suggestive of acute appendicitis and supports surgical referral, while lower scores may warrant observation or additional imaging such as ultrasound or CT scan. Scores between 5 and 6 fall into a diagnostic “gray zone,” often requiring further evaluation to avoid both negative appendectomies and missed diagnoses.