Appendicitis Signs


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McBurney's Triad
  • Pain at RIF
  • Vomiting
  • Fever (usually <38.5C, if ruptured >40C)
Signs
  1. Pointing sign
  2. McBurney sign
  3. Rovsing sign
  4. Rebound tenderness (Blumberg sign)
  5. Cutaneous hyperesthesia 
  6. Guarding
  7. Psoas sign - retrocecal
  8. Obturator - pelvic
Image result for psoas sign



Special signs in retrocecal appendix
  • Psoas sign. If severe, can see fixed hip flexion deformity. Also positive in psoas abscess.
  • With absence of usual appendicitis signs

Special signs in pelvic appendix
  • Obturator sign
  • Pain in DRE
  • Early diarrhea

Special signs in postileal appendix
  • Diarrhea
  • RIF pain
Anatomy notes:
  • Psoas m
    • Origin: Lumbar vertebrae
    • Insertion: Lesser trochanter
    • Function: Hip flexion
  • Obturator internus m
    • Origin: Ischipubic ramus
    • Insertion: Medial aspect of greater trochanter
    • Function: Abducts & laterally rotates the extended hip
*Pain is elicited when actions opposite to their functions are made??? I guess.

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