Physical Exam

Rovsing Sign

also known as Perman-Rovsing sign; Perman sign

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Video coming September 2026

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

Appendicitis

Rovsing sign positive in a child

Rule in

Somewhat helpful

Rule out

Not helpful

Evidence:Strong

Rovsing sign positive in an adult

Rule in

Somewhat helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

References

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.