Iranian Journal of Radiology

Published by: Kowsar

Alvarado Score, Ultrasound, and CRP: How to Combine Them for the Most Accurate Acute Appendicitis Diagnosis

Sonay Aydin 1 , * , Erdem Fatihoglu 1 , Hayri Ramadan 2 , Bilge S. Akhan 1 and Enver N Koseoglu 1
Authors Information
1 Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey
2 Department of Emergency Medicine, Ankara Training and Research Hospital, Ankara, Turkey
Article information
  • Iranian Journal of Radiology: April 2017, 14 (2); e38160
  • Published Online: December 18, 2016
  • Article Type: Research Article
  • Received: April 3, 2016
  • Revised: October 8, 2016
  • Accepted: December 2, 2016
  • DOI: 10.5812/iranjradiol.38160

To Cite: Aydin S, Fatihoglu E, Ramadan H, S. Akhan B, Koseoglu E N. Alvarado Score, Ultrasound, and CRP: How to Combine Them for the Most Accurate Acute Appendicitis Diagnosis, Iran J Radiol. 2017 ; 14(2):e38160. doi: 10.5812/iranjradiol.38160.

Copyright © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Gwynn LK. The diagnosis of acute appendicitis: clinical assessment versus computed tomography evaluation. J Emerg Med. 2001; 21(2): 119-23[PubMed]
  • 2. Shogilev DJ, Duus N, Odom SR, Shapiro NI. Diagnosing appendicitis: evidence-based review of the diagnostic approach in 2014. West J Emerg Med. 2014; 15(7): 859-71[DOI][PubMed]
  • 3. Apisarnthanarak P, Suvannarerg V, Pattaranutaporn P, Charoensak A, Raman SS, Apisarnthanarak A. Alvarado score: can it reduce unnecessary CT scans for evaluation of acute appendicitis? Am J Emerg Med. 2015; 33(2): 266-70[DOI][PubMed]
  • 4. Toprak H, Kilincaslan H, Ahmad IC, Yildiz S, Bilgin M, Sharifov R, et al. Integration of ultrasound findings with Alvarado score in children with suspected appendicitis. Pediatr Int. 2014; 56(1): 95-9[DOI][PubMed]
  • 5. Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004; 91(1): 28-37[DOI][PubMed]
  • 6. Puylaert JB. Acute appendicitis: US evaluation using graded compression. Radiology. 1986; 158(2): 355-60[DOI][PubMed]
  • 7. Al-Abed YA, Alobaid N, Myint F. Diagnostic markers in acute appendicitis. Am J Surg. 2015; 209(6): 1043-7[DOI][PubMed]
  • 8. Al-Khayal KA, Al-Omran MA. Computed tomography and ultrasonography in the diagnosis of equivocal acute appendicitis. A meta-analysis. Saudi Med J. 2007; 28(2): 173-80[PubMed]
  • 9. Doria AS, Moineddin R, Kellenberger CJ, Epelman M, Beyene J, Schuh S, et al. US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis. Radiology. 2006; 241(1): 83-94[DOI][PubMed]
  • 10. Carroll PJ, Gibson D, El-Faedy O, Dunne C, Coffey C, Hannigan A, et al. Surgeon-performed ultrasound at the bedside for the detection of appendicitis and gallstones: systematic review and meta-analysis. Am J Surg. 2013; 205(1): 102-8[DOI][PubMed]
  • 11. Kurane SB, Sangolli MS, Gogate AS. A one year prospective study to compare and evaluate diagnostic accuracy of modified Alvarado score and ultrasonography in acute appendicitis, in adults. Indian J Surg. 2008; 70(3): 125-9[DOI][PubMed]
  • 12. Nasiri S, Mohebbi F, Sodagari N, Hedayat A. Diagnostic values of ultrasound and the Modified Alvarado Scoring System in acute appendicitis. Int J Emerg Med. 2012; 5(1): 26[DOI][PubMed]
  • 13. Lim HK, Lee WJ, Lee SJ, Namgung S, Lim JH. Focal appendicitis confined to the tip: diagnosis at US. Radiology. 1996; 200(3): 799-801[DOI][PubMed]
  • 14. Puylaert JB. Ultrasonography of the acute abdomen: gastrointestinal conditions. Radiol Clin North Am. 2003; 41(6): 1227-42[PubMed]
  • 15. Migraine S, Atri M, Bret PM, Lough JO, Hinchey JE. Spontaneously resolving acute appendicitis: clinical and sonographic documentation. Radiology. 1997; 205(1): 55-8[DOI][PubMed]
  • 16. Wiersma F, Toorenvliet BR, Bloem JL, Allema JH, Holscher HC. US examination of the appendix in children with suspected appendicitis: the additional value of secondary signs. Eur Radiol. 2009; 19(2): 455-61[DOI][PubMed]
  • 17. Macklin CP, Radcliffe GS, Merei JM, Stringer MD. A prospective evaluation of the modified Alvarado score for acute appendicitis in children. Ann R Coll Surg Engl. 1997; 79(3): 203-5[PubMed]
  • 18. Thirumallai S, Wijesuriya SR, Mitchell A, Delriviere L. Predictive value of C-reactive protein with Alvarado score in acute appendicitis. ANZ J Surg. 2014; 84(5): 335-6[DOI][PubMed]
  • 19. Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007; 357(22): 2277-84[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments