Foreign National

Local resident+0Foreign national (+1 pt)+1

Sex

Female — no additional points+0Male (+1 pt)+1

Age

Age ≥ 40 years (or < 20 years) — no additional points+0Age 20–39 years (+1 pt)+1

RIF Pain (Right Iliac Fossa Pain)

No RIF pain+0RIF pain present (+0.5 pts)+1

Migration of Pain to RIF

No migration to RIF+0Pain migrated to RIF (+0.5 pts)+1

Anorexia (Loss of Appetite)

No anorexia+0Anorexia present (+1 pt)+1

Nausea and/or Vomiting

Neither nausea nor vomiting+0Nausea and/or vomiting (+1 pt)+1

Duration of Symptoms < 48 Hours

Duration ≥ 48 hours+0Duration < 48 hours (+1 pt)+1

RIF Tenderness on Palpation

No RIF tenderness+0RIF tenderness (+1 pt)+1

Guarding / Muscle Rigidity (Voluntary or Involuntary)

No guarding+0Guarding present (+2 pts)+2

Rebound Tenderness

No rebound tenderness+0Rebound tenderness present (+1 pt)+1

Rovsing Sign (Pain in RIF on LIF palpation)

Rovsing sign absent+0Rovsing sign positive (+2 pts)+2

Fever (Temperature > 37.5°C / 99.5°F)

Temperature ≤ 37.5°C (afebrile)+0Temperature > 37.5°C (+1 pt)+1

Elevated WBC (> 10 × 10⁹/L)

WBC ≤ 10 × 10⁹/L+0WBC > 10 × 10⁹/L (+1 pt)+1

Negative Urinalysis (No WBC or RBC in Urine)

Urinalysis positive (pyuria or hematuria present)+0Urinalysis negative (+1 pt)+1

RIPASA Score for Acute Appendicitis