Physical examination maneuver

Physical Exam

Psoas Sign

also known as Iliopsoas sign; Obraztsov 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. The test is positive if it produces pain in the right lower quadrant.

How to Interpret

Showing all 2 findings

Appendicitis

Psoas sign positive in a child
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Limited
Psoas sign positive in an adult
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Strong

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. doi:10.1001/jama.298.4.438. PMID 17652298. PMC2703737. Kharbanda AB, Taylor GA, Fishman SJ, Bachur RG. A clinical decision rule to identify children at low risk for appendicitis. Pediatrics. 2005 Sep;116(3):709-716. PMID 16140712.
  • Wagner JM, McKinney WP, Carpenter JL. Does this patient have appendicitis? JAMA. 1996 Nov 20;276(19):1589-1594. doi:10.1001/jama.1996.03540190061030. PMID 8918857.
  • Cope Z. The Early Diagnosis of the Acute Abdomen. London: Henry Frowde, Hodder & Stoughton; 1921.

Research last updated September 9, 2026.

Related Diagnoses

Appendicitis

Related Systems / Regions

AbdomenGastrointestinal

Related Bedside Tests

🎬Video coming Sept 2026
Abdomen Palpation
Rule in:VHPyloric Stenosis, HAppendicitis, SHDiverticulitis +32 more
Rule out:HAppendicitis, SHDiverticulitis, SHPyloric Stenosis +32 more
🎬Video coming Sept 2026
McBurney Point Palpation
aka McBurney sign
Rule in:IEAppendicitis
Rule out:IEAppendicitis
🎬Video coming Sept 2026
Obturator Sign
aka Cope obturator test
Rule in:SHAppendicitis
Rule out:NHAppendicitis
🎬Video coming Sept 2026
Rebound Tenderness
aka Blumberg sign
Rule in:SHAppendicitis, MHPeritonitis, IEDiverticulitis +1 more
Rule out:SHAppendicitis, SHPeritonitis, IEDiverticulitis +1 more
🎬Video coming Sept 2026
Rovsing Sign
aka Perman-Rovsing sign; Perman sign
Rule in:SHAppendicitis, IEPeritonitis
Rule out:NHAppendicitis, IEPeritonitis
🎬Video coming Sept 2026
Abdomen Auscultation
Rule in:VHRenovascular Hypertension, MHBowel Obstruction, IEAbdominal Aortic Aneurysm +9 more
Rule out:MHRenovascular Hypertension, NHBowel Obstruction, IEAbdominal Aortic Aneurysm +9 more