Clinical Signs in Appendicitis

Clinical Signs in AppendicitisDescription
1Blumberg’s signRebound tenderness
2Aure-Rozanova’s sign Increased pain on palpation with finger in the right inferior lumbar triangle
3Bartomier-Michelson’s sign Increased pain on palpation at the right iliac region as the person being examined lies on their left side compared to when they lie on their back
4Dunphy’s sign Increased pain in the right lower quadrant with coughing
5Hamburger sign The patient refuses to eat Anorexia is 80% sensitive for appendicitis
6Kocher’s sign Pain starts in the umbilical region with a subsequent shift to the right iliac regionAlso called Kosher’s sign
7Massouh’s signFirm swish of the examiner’s index and middle finger across the patient’s abdomen from xiphoid sternum to first the left and then the right iliac fossa. A positive Massouh sign is a grimace of the patient upon a right sided (and not left) sweep
8Obturator sign:The person being evaluated lies on her or his back with the hip and knee both flexed at ninety degrees. The examiner holds the person’s ankle with one hand and knee with the other hand. The examiner rotates the hip by moving the person’s ankle away from his or her body while allowing the knee to move only inward.A positive test is pain with internal rotation of the hip.
9Psoas signRight lower-quadrant pain that is produced with either the passive extension of the right hip or by the active flexion of the person’s right hip while supine.Also known as -“Obraztsova’s sign”
10Rovsing’s signPain in the lower right abdominal quadrant with continuous deep palpation starting from the left iliac fossa upwards (counterclockwise along the colon).
Rosenstein’s signIncreased pain in the right iliac region as the person is being examined lies on their left side.Also known as -Sitkovsky’s sign
Perman’s signIn acute appendicitis palpation in the left iliac fossa may produce pain in the right iliac fossa
Clinical Signs in Appendicitis

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