How to tell if it's muscle strain or appendicitis?

Fever?: Appendicitis usually starts as vague pain near umbilicus the migrates to right lower quadrant. Usually associated with fever and nausea. Muscle strain will hurt when moving and will have no fever or nausea.

Difficult: To tell sometimes, because appendicitis symptoms are varied. Usually, nausea and vomiting precedes pain in appendicitis, whereas if it is pain of musculoskeletal origin, it is the other way around. The only way to know for certain is with a ct scan, . And even they can't tell. You should go to er if you have right lower quadrant abd pain with nausea and vomiting.