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Table 2 Modified clinical practice and harmonic ultrasonographic grading score (MCPGS):

From: Role of clinical judgment and tissue harmonic imaging ultrasonography in diagnosis of paediatric acute appendicitis

    1 0 Score
Clinical data General - Fever Yes No  
   - HR > 120/min. < 120/min.  
   - Vomiting Yes No  
  Abdominal Abd. Pain    
   - Localized Yes No  
   - History of similar - attacks No Yes  
   - Character Constant Intermittent  
   - Severity Intolerable Tolerable  
   - Course Progressive Regressive  
   - Relief by antispasmodic No Yes  
   - Bowel Habit alteration Yes No  
   - Tenderness Yes No  
   - Guarding or rigidity Yes No  
   - +ve P.R.
Associated intra- abdomin,. Disease
Yes
No
No
Yes
 
Investigations Laboratory - High WBCs
- Elevated CRP
Yes
Yes
No
No
 
   - Urine analysis (Findings of UTI) No Yes  
  Tissue Harmonic
U.S. RLQ
-Aperistaltic non-
Compressible blind ended tubular structure
Yes No  
   -Distinct thickened appendicial wall layers Yes No  
   - Outer diameter > 6 mm Yes No  
   -Target sign appearance Yes No  
   -Appendicolith(s) Yes No  
   -Periappendiceal
fluid collection
Yes No  
   - Echogenic
Prominent
pericecal fat
Appendicolith
Yes No  
   - +ve findings in female Adnxae No Yes  
Total score  
  1. Interpretation of results:
  2. 15 - 25 = highly suggestive of appendicitis.
  3. 8 - 14 = Patient needs repeated evaluation for conclusive result.
  4. 0 - 7 = the diagnosis of acute appendicitis in not likely.