Physical examination maneuver

Physical Exam

Psoas Sign

also known as Iliopsoas sign; Obraztsov sign
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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
Minimally helpful
Evidence:Moderate
Psoas sign positive in an adult
Rule in
Somewhat helpfulWide CI
Rule out
Not helpful
Evidence:Strong

Related Bedside Tests

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

Related Systems / Regions

AbdomenGastrointestinal

Related Diagnoses

Appendicitis

Related Chief Complaints

Abdominal PainAbdominal Pain in a ChildAbdominal TendernessChillsFatigueFeverIrritabilityLoss of AppetiteLow-grade FeverNauseaNausea and VomitingPain with MovementPeriumbilical PainRefusal to EatRight Lower Quadrant PainRight Lower Quadrant TendernessVomiting

References

  • Santillanes G, Simms S, Gausche-Hill M, Diament M, Putnam B, Renslo R, Lee J, Tinger E, Lewis RJ. Prospective evaluation of a clinical practice guideline for diagnosis of appendicitis in children. Acad Emerg Med. 2012;19(8):886-893. doi:10.1111/j.1553-2712.2012.01402.x. PMID 22849662. PMC4318553.
  • 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.