Rovsing's sign
This article needs more primary sources. (August 2019) |
Rovsing's sign | |
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LLQ is palpated. | |
Differential diagnosis | appendicitis |
Rovsing's sign, named after the Danish surgeon
In acute appendicitis, palpation in the left iliac fossa may produce pain in the right iliac fossa.
Referral of pain
This anomaly occurs because the
Because the
Process
Pathologic explanation: This maneuver elicits tenderness in the right lower abdomen, because contents of the left lower abdomen are shifted upon application of pressure, further irritating the inflamed peritoneum.
A Rovsing's sign is elicited by pushing on the abdomen far away from the appendix in the left lower quadrant. The appendix, in a large majority of people, is located in the right lower quadrant. While this maneuver stretches the entire peritoneal lining, it only causes pain in any location where the peritoneum is irritating the muscle. In the case of appendicitis, the pain is felt in the right lower quadrant despite pressure being placed elsewhere.
Most practitioners push on the left lower quadrant to see where the patient complains of pain. If pain is felt in the right lower quadrant, then there may be an inflamed organ or piece of tissue in the right lower quadrant. The appendix is generally the prime suspect, although other pathology can also give a "positive" Rovsing's sign. If left lower quadrant pressure by the examiner leads only to left-sided pain or pain on both the left and right sides, then there may be some other
The eponym Rovsing sign is also used in patients with horseshoe kidney, consisting of abdominal pain, nausea, and vomiting with hyperextension of the spine.
While Rovsing's test is frequently performed in suspicion of appendicitis, its sensitivity and specificity have not been adequately evaluated, and is considered by some to be an antiquated examination test.[4]
See also
- Abdominal exam
- McBurney's point
- Psoas sign
- Obturator sign
References
- ^ Rovsing's sign.
- ^ Perman, ES (1904). "Om indikationerna för operation vid appendicit samt redogörelse for å Sabbatsbergs sjukhus opererade fall" [About the indications for surgery in appendicitis and an account of cases at Sabbatsberg Hospital]. Hygiea. 66 (2): 797–847.
- PMID 6381936.
- PMID 14253734.