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The patient lies on a couch. The examiner gently stretches the right spermatic cord using the thumb and index finger right about the testis in the right scrotum. For a patient with appendicitis, this causes pain in the right iliac fossa. [2]
The sign indicates aggravation of the parietal peritoneum by stretching or moving. Positive Blumberg's sign is indicative of peritonitis, [3] which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant.
Markle's sign, or jar tenderness, is a clinical sign in which pain in the right lower quadrant of the abdomen is elicited by the heel-drop test (dropping to the heels, from standing on the toes, with a jarring landing).
Appendicitis is inflammation of the appendix. [2] Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and decreased appetite. [2] However, approximately 40% of people do not have these typical symptoms. [2]
Rovsing's sign, named after the Danish surgeon Niels Thorkild Rovsing (1862–1927), [1] is a sign of appendicitis.If palpation of the left lower quadrant of a person's abdomen increases the pain felt in the right lower quadrant, the patient is said to have a positive Rovsing's sign and may have appendicitis.
The hamburger sign is used in the diagnosis of appendicitis. [1] The sign is used to rule out that disease, with the physician inquiring if the patient would like to consume their favourite food. [2]
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
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