Pain in the right lower quadrant developing with deep palpation of the left lower quadrant is a positive which sign?

• A. Psoas sign
• B. Murphy's sign
• C. Rovsing's sign
• D. Obturator sign

Answer: (C)

This item hinges on Rovsing's sign, a clue of peritoneal irritation associated with appendicitis. Pressing deeply in the left lower quadrant increases peritoneal irritation and often triggers pain in the right lower quadrant where the inflamed appendix sits. The presence of this referred RLQ pain with LLQ palpation defines a positive sign.

For context, psoas sign occurs with pain in the right lower quadrant when the right hip is extended or the patient flexes the hip against resistance, reflecting psoas muscle irritation. Murphy's sign is RUQ pain with inspiratory arrest during palpation, pointing to cholecystitis. Obturator sign is pain with internal rotation of a flexed right hip, indicating irritation near the obturator internus, often from pelvic or retrocecal appendicitis.