Physical examination maneuver

Physical Exam

Rovsing Sign

also known as Perman-Rovsing sign; Perman sign
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How to Perform

Place a flat hand in the left lower quadrant directly on skin and palpate deeply. The test is positive if it produces pain in the right lower quadrant.

How to Interpret

Showing 2 of 3 findings

Appendicitis

Rovsing sign positive in a child
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:StrongResearch in progress
Rovsing sign positive in an adult
Rule in
Somewhat helpfulNo CI
Rule out
Not helpfulNo CI
Evidence:Moderate

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
Rebound Tenderness
aka Blumberg sign
Rule in:SHAppendicitis, MHDiverticulitis, MHPeritonitis +1 more
Rule out:SHAppendicitis, SHPeritonitis, MHDiverticulitis +1 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
Psoas Sign
aka Iliopsoas sign; Obraztsov sign
Rule in:SHAppendicitis
Rule out:MHAppendicitis
🎬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

AppendicitisPeritonitis

Related Chief Complaints

Abdominal DistensionAbdominal PainAbdominal TendernessAnorexiaChillsFeverLoss of AppetiteLow-grade FeverNauseaNausea and VomitingPain with MovementPeriumbilical PainRight Lower Quadrant PainRight Lower Quadrant TendernessRight-sided Abdominal PainRigid AbdomenVomiting

References

Research in progress on one or more findings above; ratings may change.

  • Kinesya E, Cintya EP, Dorothy MJ, Ennaidi NN, Rusti HF, Mannagalli Y, Pasaribu EA. Diagnostic accuracy of Alvarado score components in patients with appendicitis: Systematic review and meta-analysis approach. Health Sciences Review. 2022;2:100018. doi:10.1016/j.hsr.2022.100018.
  • Benabbas R, Hanna M, Shah J, Sinert R. Diagnostic accuracy of history, physical examination, laboratory tests, and point-of-care ultrasound for pediatric acute appendicitis in the emergency department: a systematic review and meta-analysis. Acad Emerg Med. 2017;24(5):523-551. doi:10.1111/acem.13181. PMID: 28214369.
  • Rovsing NT. Indirektes Hervorrufen des typischen Schmerzes an McBurney's Punkt: Ein Beitrag zur Diagnostik der Appendicitis und Typhlitis. Zentralbl Chir. 1907;34:1257-1259.

Research last updated September 9, 2026.