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rovsing sign

Rovsing sign

Rovsing’s sign is a sign of appendicitis. Positive Rovsing sign is if palpation of the lower left quadrant of a person’s abdomen results in more pain in the right lower quadrant, the patient may have appendicitis.

Other clinical signs have been described to help in the diagnosis of appendicitis. Some of them are the obturator sign (right lower quadrant pain on internal rotation of the hip), and the psoas sign (pain with extension of the ipsilateral hip) 1.

Rovsings test

A Rovsing’s sign is elicited by pushing on the abdomen far away from the appendix in the left lower quadrant as in most people the appendix is 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 pathologic etiology. This may include causes relating to the bladder, uterus, descending (left) colon, fallopian tubes, ovaries, or other structures.

References
  1. Wray CJ, Kao LS, Millas SG, Tsao K, Ko TC. Acute appendicitis: controversies in diagnosis and management. Curr Probl Surg. 2013 Feb;50(2):54-86.
Health Jade Team

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