Massouh's sign

Massouh's sign is a clinical sign used in the diagnosis of appendicitis. It was first described by Dr. Farid Massouh in 2008. The sign is positive when a patient lying supine on an examination table lifts their head and shoulders off the table, causing a grimace of pain. This is due to the stretching of the inflamed peritoneum over the swollen appendix.

Procedure

To perform the test for Massouh's sign, the patient is asked to lie down flat on their back on an examination table. The examiner then asks the patient to lift their head and shoulders off the table, without using their hands. If the patient grimaces in pain during this movement, the sign is considered positive.

Clinical significance

Massouh's sign is used as a diagnostic tool in the assessment of patients with suspected appendicitis. It is one of several physical examination signs that can be used to increase the clinical suspicion of appendicitis, along with signs such as McBurney's point tenderness and Rovsing's sign. However, like all clinical signs, it is not definitive and must be used in conjunction with other clinical findings and diagnostic tests.

Limitations

While Massouh's sign can be a useful tool in the diagnosis of appendicitis, it is not without limitations. The sign may be negative in patients with early appendicitis, before the peritoneum has become significantly inflamed. Additionally, the sign may be positive in conditions other than appendicitis that cause peritoneal irritation, such as pelvic inflammatory disease or peritonitis.

See also

• Appendicitis
• McBurney's point
• Rovsing's sign
• Peritoneum
• Peritonitis
• Pelvic inflammatory disease