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Psoas sign is when the patient lies supine and attempts to flex their hip against resistance. Place your hand on their thigh and ask them to lift their leg. If they have pain in the RLQ – this is a positive Psoas sign.
Absent or decreased bowel sounds, a positive psoas sign, a positive obturator sign, and a positive Rovsing sign are most reliable for ruling in acute appendicitis in children.
The psoas sign, also known as Cope's sign (or Cope's psoas test[1]) or Obraztsova's sign, [2] is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
Psoas sign. If your appendix is behind your colon rather than in front, appendicitis might irritate your psoas muscle. You might find yourself flexing your right hip to shorten the muscle, which relieves pain. A healthcare provider might try extending your right hip or rotating it outward. If this hurts, it’s called the psoas sign.
The psoas sign involves RLQ pain on passive extension of the hip while the patient is in a left lateral decubitus position. An inflamed appendix that is retroperitoneal will irritate the iliopsoas muscle group of the hip flexors.
A positive psoas sign is right lower quadrant pain with right hip extension or right thigh flexion against resistance. This pain occurs due to irritation of the psoas muscle by the inflamed appendix. Patients often flex the hip to shorten the muscle to relieve this pain.
Appendicitis: inflammation of the appendix, common cause of acute abdominal pain in children; 20-30% of paediatric acute abdominal pain cases. Pathophysiology: typically caused by obstruction of the appendix opening due to faecoliths or lymphoid hyperplasia.