Alvarado score: Studies that look at the score's ability to rule out appendicitis (using Alvarado < 3-4) have a sensitivity of 96%. Studies that use the score to rule in appendicitis (using Alvarado > 6-7) have a sensitivity of 58-88%, depending on the study and score cutoffs used. McKay et al. recommend a CT scan for a score of 4-6 and surgical consultation for a score ≥ 7. For a score of ≤ 3, the authors suggest that a CT scan is unnecessary for diagnosing appendicitis given the low likelihood of appendicitis. A score is assigned by the following variables. +2 points - Right lower quadrant tenderness +1 point - Elevated temperature (>37.3°C or 99.1°F) +1 point - Rebound tenderness +1 point - Migration of pain to the right lower quadrant +1 point - Anorexia +1 point - Nausea or vomiting +2 point - Leukocytosis > 10,000 +1 point - Leukocyte left shift
Rovsing’s sign: Pain in the RLQ with palpation of the left lower quadrant. Dunphy’s sign: Increased pain with coughing (a cough jostles the inflamed peritoneum). Psoas sign: Pain on passive extension of the right thigh. It is present when the inflamed appendix is retrocecal and overlying the right psoas muscle. Obturator sign: Pain on passive internal rotation of the hip when the right knee is flexed. It is present when the inflamed appendix is in contact with the obturator internus muscle.
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6:35 appendiceal malignancy
9:38 typhlitis
10:45 ogilvie's syndrome
great
Alvarado score: Studies that look at the score's ability to rule out appendicitis (using Alvarado < 3-4) have a sensitivity of 96%. Studies that use the score to rule in appendicitis (using Alvarado > 6-7) have a sensitivity of 58-88%, depending on the study and score cutoffs used.
McKay et al. recommend a CT scan for a score of 4-6 and surgical consultation for a score ≥ 7. For a score of ≤ 3, the authors suggest that a CT scan is unnecessary for diagnosing appendicitis given the low likelihood of appendicitis.
A score is assigned by the following variables.
+2 points - Right lower quadrant tenderness
+1 point - Elevated temperature (>37.3°C or 99.1°F)
+1 point - Rebound tenderness
+1 point - Migration of pain to the right lower quadrant
+1 point - Anorexia
+1 point - Nausea or vomiting
+2 point - Leukocytosis > 10,000
+1 point - Leukocyte left shift
u confused psoas sign with obturator sign, pls make a correction
Rovsing’s sign: Pain in the RLQ with palpation of the left lower quadrant.
Dunphy’s sign: Increased pain with coughing (a cough jostles the inflamed peritoneum).
Psoas sign: Pain on passive extension of the right thigh. It is present when the inflamed appendix is retrocecal and overlying the right psoas muscle.
Obturator sign: Pain on passive internal rotation of the hip when the right knee is flexed. It is present when the inflamed appendix is in contact with the obturator internus muscle.