Acute appendicitis is the most common cause of an acute abdomen requiring surgery with a life time risk of 7%.Symptoms of acute appendicitis overlap with other conditions making it a challenge to diagnose it in the early stages.

    Clinical prediction rules(CPR) has got a diagnostic potential in finding the key signs and symptoms of the condition.CPR has also got the potential to reduce diagnostic errors.CPR

is the need of the hour in poor resource settings to avoid unwanted emergency surgeries and to prevent missing the complications.

   In 1986 Alvarado constructed a 10 point clinical scoring system called the Alvarado scoring system.Its acronym is MANTRELS.Its for diagnosing acute appendicitis with the symptoms and signs. Alvarado score enables risk stratification in patients presenting with abdominal pain linking the probability of appendicitis to recommendations regarding discharge,observation or surgical interventions.

      However imaging with Computerised Tomography scan(CT Scan) is a better way to diagnose the condition. But keeping in mind the time lag, exposure to radiation, cost and variable availability of the imaging modality means that the Alvarado scoring may be valuable diagnostic diagnostic aid when suspecting acute appendicitis as a cause for acute abdomen particularly in low resource countries where imaging is not an option