Pinto Leite et al proposed an Algorithm for Interpretation of Appendicitis CT in Symptomatic Patients¹

• 1. Excludes appendicitis
  • CT findings: < 6-mm appendix or  > 6-mm appendix completely gas-filled.
    Recommendation : Work up other causes of RLQ pain
• 2. Possible appendicitis
  • CT findings: 6- to 10-mm appendix without any other CT signs.
    Recommendation : Observation if symptomatic
• 3. Probable appendicitis
  • CT findings: 6- to 10-mm appendix +wall thickening +  wall hyperenhancement (no fat stranding).
    Recommendation : Surgery if symptomatic
• 4. Definite appendicitis
  • CT findings: > 10-mm appendix or 6- to 10-mm appendix + wall thickening + wall hyperenhencement+ fat stranding.
    Recommendation: Surgery if symptomatic

In our case example above the imaging findings are suggestive of "probable appendicitis". Patient subsequently underwent appendectomy without complication.