| Clinical Signs in Appendicitis | Description | |
1 | Blumberg’s sign | Rebound tenderness | |
2 | Aure-Rozanova’s sign | Increased pain on palpation with finger in the right inferior lumbar triangle | |
3 | Bartomier-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 | |
4 | Dunphy’s sign | Increased pain in the right lower quadrant with coughing | |
5 | Hamburger sign | The patient refuses to eat | Anorexia is 80% sensitive for appendicitis |
6 | Kocher’s sign | Pain starts in the umbilical region with a subsequent shift to the right iliac region | Also called Kosher’s sign |
7 | Massouh’s sign | Firm 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 |
8 | Obturator 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. |
9 | Psoas sign | Right 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” |
10 | Rovsing’s sign | Pain in the lower right abdominal quadrant with continuous deep palpation starting from the left iliac fossa upwards (counterclockwise along the colon). | |
| Rosenstein’s sign | Increased 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 sign | In acute appendicitis palpation in the left iliac fossa may produce pain in the right iliac fossa | |