Physical examination maneuver

Physical Exam

Psoas Sign

also known as Iliopsoas sign; Obraztsov's sign
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Video coming September 2026

How to Perform

Have the patient lie on the left side while you passively extend the right hip. A positive test is pain in the right lower quadrant.

How to Interpret

Showing all 2 findings

Appendicitis

Psoas sign positive
Rule in
Somewhat helpful
Rule out
—
Evidence:Strong
Psoas sign positive
Rule in
Somewhat helpful
Rule out
—
Evidence:Limited

References

  • Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA. 2007 Jul 25;298(4):438-451. PMID 17652298; DOI 10.1001/jama.298.4.438. Free PMC article via Duke Scholars and JAMA Network abstract.
  • Wagner JM, McKinney WP, Carpenter JL. Does this patient have appendicitis? JAMA 1996 Nov 20;276(19):1589-1594. PMID 8918857. doi:10.1001/jama.1996.03540190061030.
  • Cope Z. The Early Diagnosis of the Acute Abdomen. London: Henry Frowde, Hodder & Stoughton; 1921.

Related Systems / Regions

AbdomenGastrointestinal

Related Bedside Tests

🎬Video coming Sept 2026
Temperature
Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more
Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more
🎬Video coming Sept 2026
Abdomen Palpation
Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more
Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more
🎬Video coming Sept 2026
McBurney Point Palpation
aka McBurney's sign
Rule in:IEAppendicitis
Rule out:IEAppendicitis
🎬Video coming Sept 2026
Obturator Sign
aka Cope's obturator test
Rule in:SHAcute Appendicitis
🎬Video coming Sept 2026
Rebound Tenderness
aka Blumberg's sign
Rule in:SHAppendicitis, MHPeritonitis, IEDiverticulitis +1 more
Rule out:SHAppendicitis, SHPeritonitis, IEDiverticulitis +1 more
🎬Video coming Sept 2026
Rovsing Sign
Rule in:SHAppendicitis, IERight-sided Peritoneal Irritation
Rule out:IERight-sided Peritoneal Irritation