The diagnostic process begins with a thorough clinical examination. Doctors look for key signs like right upper quadrant pain, fever, and a positive Murphy's sign. This sign, where pain increases when the doctor presses on the gallbladder area during a deep breath, is like a secret handshake between the patient's body and the doctor's trained hands, signaling potential gallbladder inflammation.

Next, doctors order blood tests to look for signs of inflammation and infection. An elevated white blood cell count often indicates the body is fighting an infection. Liver function tests may show mild elevations in certain enzymes. These tests are like reading the body's internal diary, revealing hidden clues about what's happening beneath the surface.

Imaging studies are crucial for confirming the diagnosis of acute cholecystitis. Ultrasound is usually the first choice, offering a real-time view of the gallbladder. It can reveal gallstones, thickening of the gallbladder wall, and fluid around the gallbladder - all signs of inflammation. If ultrasound results are unclear, doctors may use other imaging tests like CT scans or a special nuclear medicine test called a HIDA scan. These advanced imaging techniques are like giving doctors X-ray vision, allowing them to see detailed pictures of the gallbladder and surrounding structures.

Diagnosing acute cholecystitis is rarely based on a single test. Instead, doctors consider the whole picture - symptoms, physical exam findings, lab results, and imaging studies. It's like assembling a jigsaw puzzle, where each piece of information helps complete the diagnostic picture. This comprehensive approach helps ensure an accurate diagnosis and guides appropriate treatment.

With today's advanced diagnostic tools and techniques, doctors can accurately identify acute cholecystitis and start appropriate treatment quickly.