15. 42yoM with RUQ pain

Question 1

Abdominal Exam - Appendicitis

Answer 1

Psoas sign - Passive extension of patient’s thigh as s/he lies on his/her side with knees extended, or asking the patient to actively flex his/her thigh and hip causes abdominal pain, often indicative of appendicitis.

Obturator Sign - Examiner has patient supine with right hip flexed to 90 degrees- takes patient’s right ankle in his right hand as he uses his left hand to externally/internally rotate patient’s hip by moving the knee back and forth. Elicitation of pain in the abdomen implies acute appendicitis.