The diagnosis of acute appendicitis hinges upon the triad of medical diagnosis:
History - Traditionally the history gives the diagnosis and the examination confirms it. Appendicitis generally begins with a vague feeling of unwellness, associated with pyrexia, nausea and vague abdominal pain sited around the umbilicus.
With time the symptoms progress to severe pain located in the lower right of the abdomen. The patient may become flushed, with a raised pulse rate and temperature.
Physical examination - .The patient appears unwell, with a temperature and raised pulse rate. Movement is painful and the patient remains still in the position of greatest comfort.
The abdomen is tender to the touch and muscular spasm of the abdominal wall is common.
Specialised investigations - The value of these, when they have a poor level of confidence is questionable. They are sometimes employed when the diagnosis is in some doubt; to offer an alternate diagnosis, rather than confirm the suspected diagnosis.
These tests include ultrasound and CT.