Which sign is most commonly used to assess appendiceal tenderness in the right lower quadrant?

• A. McBurney's point
• B. Murphy's sign
• C. Obturator sign
• D. Rovsing's sign

Answer: (A)

Tenderness at McBurney's point is the sign most commonly used to assess appendiceal tenderness in the right lower quadrant. This point is located about one-third of the distance from the anterior superior iliac spine to the umbilicus, along the iliac region. In acute appendicitis, irritation of the peritoneum over this area produces localized tenderness, often with guarding and sometimes rebound, making it a classic bedside indicator of appendiceal inflammation.

Other signs you might hear about are peritoneal or visceral clues but are less consistently reliable. Murphy's sign points to gallbladder disease and involves an inspiratory arrest during RUQ palpation. Rovsing's sign is pain in the RLQ when the LLQ is palpated, reflecting peritoneal irritation. The obturator sign is pain with internal rotation of the flexed right hip, suggesting pelvic or retrocecal appendix irritation. These can support the diagnosis but McBurney's point tenderness remains the most straightforward and commonly used indication of appendiceal tenderness.