Connecticut medicine
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Connecticut medicine · Mar 1999
Comparative StudyComparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis.
The Alvarado score assigns a numerical value to eight signs and symptoms associated with acute appendicitis. Practically speaking, the Alvarado score is equivalent to one's degree of clinical suspicion. Ultrasound is used in many institutions to aid in the diagnosis of acute appendicitis. The following study compares the accuracy of the two modalities and examines the value of using both modalities together. ⋯ When comparing ultrasound to the Alvarado score for the diagnosis of acute appendicitis, neither one is significantly advantageous. However, the false positive rate is reduced to zero when both studies are positive and ultrasound improved diagnostic accuracy when the Alvarado score was negative or equivocal. There is no advantage of ultrasound over the Alvarado score for the diagnosis of acute appendicitis. Ultrasound is unnecessary when one's degree of clinical suspicion is high. However, the additional information provided by ultrasound does improve diagnostic accuracy in the case of a negative or equivocal Alvarado score. Acute appendicitis is the most common surgical abdominal emergency with a lifetime prevalence of approximately one in seven.