Rovsing's sign

Rovsing's Sign

Introduction

Rovsing's Sign is a clinical sign used to assist in the diagnosis of Appendicitis, named after Danish surgeon Niels Thorkild Rovsing (1862–1927). It is a significant indication in the physical examination for suspected appendicitis cases.

Historical Background

• The sign was first described by Swedish surgeon Emil Samuel Perman in 1904 in the journal Hygiea.
• It was later popularized and named after Niels Thorkild Rovsing, who extensively researched appendicitis.

Clinical Description

Rovsing's sign is observed during a physical examination where:

• Palpation in the left lower quadrant of the abdomen results in pain in the right lower quadrant.
• This response is considered a positive Rovsing's sign.
• The phenomenon is due to the pressure transmitting through the colon, causing distension and pain in the area of the inflamed appendix.

Relevance in Diagnosis

• A positive Rovsing's sign is a suggestive indicator of acute appendicitis but is not definitive on its own.
• It is typically used in conjunction with other signs and symptoms, as well as diagnostic tests like ultrasound or CT scans.

Mechanism and Pathophysiology

• The pain response is attributed to the irritation or inflammation of the peritoneal lining near the appendix.
• When pressure is applied to the left side, it exacerbates the pain on the right side where the inflamed appendix is located.

Differential Diagnosis

While Rovsing's sign is indicative of appendicitis, similar symptoms may be present in other conditions, requiring differential diagnosis:

• Conditions like Meckel's Diverticulum, right-sided diverticulitis, or gynecological pathologies might present with similar symptoms.

Importance in Medical Practice

• Rovsing's sign remains an important physical examination tool in modern medicine, particularly in settings where advanced diagnostic tools are not readily available.

External Links

• National Center for Biotechnology Information: Appendicitis
• UpToDate: Acute Appendicitis in Adults: Clinical Manifestations and Diagnosis

References

• Journal of Clinical Gastroenterology: Rovsing's Sign and the Sonographic Diagnosis of Appendicitis
• ScienceDirect: Revisiting Rovsing's Sign: Clinical Significance and Biomechanical Perspective

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