Which sign is elicited by palpating the left lower quadrant to produce RLQ pain?

• A. Psoas sign
• B. Rebound tenderness
• C. Rovsing's sign
• D. Rectal exam

Answer: (C)

Rovsing's sign is tested to detect peritoneal irritation from suspected appendicitis. When you press on the left lower quadrant, the impulse can irritate the peritoneum that lines the abdomen near the appendix. If the inflamed appendix irritates the parietal peritoneum, this pressure often causes pain to be felt in the right lower quadrant. That referral of pain to the RLQ after palpating the LLQ is what makes Rovsing's sign positive and suggestive of acute appendicitis.

This differs from the psoas sign, which is about pain when the hip is extended or the thigh is actively flexed against resistance—pointing to irritation of the iliopsoas muscle, often with a retrocecal appendix. Rebound tenderness is a general test for peritoneal irritation, observed as pain upon sudden release of abdominal pressure, not specifically tied to left-sided palpation provoking right-sided pain. Rectal examination is a separate assessment used to evaluate pelvic or colorectal issues.