Since the symptoms of appendicitis can resemble those of other conditions, it is important to use specific tests and a physical examination to differentiate it. These methods include:

Medical history:

A detailed history is taken to exclude other possible conditions. You may be asked about the duration of abdominal pain, especially if it has lasted 12-24 hours without fever or diarrhea, and whether the pain has moved to the lower right abdomen along with tenderness. Your doctor will also inquire about any medications you are currently taking for other conditions.

Physical examination:

During a physical exam, the doctor will ask you to point to the area of the abdomen where you feel pain. They will gently press on this area to check for rigidity and observe if you tense your abdominal muscles in response to pressure, which indicates inflammation in the appendix.

Note: Early stages of appendicitis might show subtle or no physical symptoms.

Imaging tests:

These tests help determine if the pain is caused by an obstruction, inflammation, or abscess in the appendix. They include:

Abdominal ultrasound: This test uses sound waves to create images of the internal organs and is a common first step for evaluating acute abdominal pain.

Abdominal CT scan: CT scans use X-rays to produce detailed images and are highly accurate in diagnosing appendicitis, with over 95% accuracy.

Abdominal MRI: MRI uses strong magnetic and radio waves to create detailed 3D images of the abdomen. Although it’s expensive and requires specialized expertise, MRI is an effective tool for diagnosing appendicitis.

Note: Pregnant women and children are generally advised to undergo an ultrasound or MRI instead of a CT scan to reduce radiation exposure.

Abdominal X-rays: While not commonly used to diagnose acute appendicitis, X-rays may reveal appendicoliths (hardened stool or mucus).

Barium enema test: This can be useful for detecting appendicitis in patients with atypical symptoms, as it can show inflammation in the appendix as well as abnormalities in the colon or pelvis.

Laboratory tests:

Complete blood count (CBC): A CBC can reveal a high white blood cell count, which may indicate an infection.

C-reactive protein test: This test checks for inflammation, which could point to other underlying causes such as autoimmune disorders.

Urine and stool tests: These tests are used to check for infection, inflammation, or kidney stones that could cause similar symptoms.

Other tests:

Diagnostic laparoscopy: If other imaging methods don’t provide clear results, a laparoscopy can be performed to directly view the abdominal and pelvic areas and identify the cause of the pain.