Appendicitis: The Daily PANCE Blueprint

Appendicitis: The Daily PANCE Blueprint

Which of the following is not a test for acute appendicitis?

A. Murphy sign
B. Rovsing sign
C. Obturator sign
D. Psoas sign
E. McBurney sign

Answer and topic summary

The answer is A. Murphy sign

Appendicitis is one of the most common indications for emergent abdominal surgery. The most common physical exam finding is RLQ tenderness. There are some tests that may help with the diagnosis — keep in mind though that these tests/signs are NOT sensitive.

Rovsing sign: pain in the RLQ with palpation of the LLQ (indicative of peritoneal irritation)

McBurney sign: tenderness about 2 inches from the ASIS (on a straight line from ASIS to the umbilicus)

Psoas sign: RLQ pain with passive right hip extension

Obturator sign: flexion of the right hip and knee, followed by internal rotation of right hip elicits RLQ pain

Murphy’s sign is positive in acute cholecystitis, not appendicitis. A positive test is RUQ pain on inspiration.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint GI and NutritionDiseases of the Small IntestineAppendicitis

Also covered as part of the Emergency Medicine EOR, Family Medicine EOR, Pediatric EOR, and General Surgery EOR topic list