Background: Acute appendicitis is one of the most common cause of acute abdomen for which a prompt diagnosis and treatment is required to decrease morbidity and mortality. Routine history and clinical examination both remain the most effective and practical diagnostic modalities. Material and Methods: A prospective study conducted during the period of October 2017 up to October 2019 on symptomatic patients presented with complaints of right iliac fossa pain. Clinical history with clinical examination, and radiological record of patient had been taken according to the proforma attached. Diagnosis was confirmed by postoperative histopathological examination reports. We compared combined modified RIPASA score and Ultrasound with Histopathological reports. Result: Sensitivity, specificity and diagnostic accuracy of modified RIPASA score was 89.5%, 60% and 88% respectively. Sensitivity, specificity and diagnostic accuracy of USG was 70.5%, 60% and 70% respectively. On combining modified RIPASA score with USG, Sensitivity, specificity and diagnostic accuracy were 97.8%, 60% and 95% respectively. It is noted that by adding USG with modified RIPASA score sensitivity and diagnostic accuracy is increased and negative appendectomy is reduced to 5%. Conclusion: On adding USG with modified RIPASA score there is increase in sensitivity and diagnostic accuracy. So modified RIPASA score with USG can be used in patient with RIF pain for making diagnosis of acute appendicitis.

Keywords: Right iliac fossa pain; Acute appendicitis; Modified RIPASA score; USG.