A patient presents to the clinic with severe pain in the right lower quadrant, anorexia and vomiting. Which of the following is not a sign of appendicitis?
Correct Answer: Murphy's sign
Description: Rovsing's sign, Obturator sign and Psoas sign are seen in appendicitis. Positive Murphy's sign is seen in acute cholecystitis. It is an ultrasonographic sign in which there is an area of maximum tenderness directly under the probe. Rovsing's sign refers to pain in the right lower quadrant when palpatory pressure is exeed in the left lower quadrant. Obturator sign refers to presence of hypogastric pain on stretching the obturator internus due to its irritation in the pelvis. This test is performed by passive internal rotation of the flexed right thigh with the patient supine. Psoas sign is positive in retrocecal appendicitis. In this, irritation of the of the psoas muscle gives rise to pain when the patient's right thigh is extended from the flexed position. Ref: Abdominal Ultrasound By Mike Stocksle, page 77 ; Schwaz's Principles of Surgery, 9e, chapter 30
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