Physical Assessment: Checking for Rovsing's Sign

A Rovsing's sign is elicited by palpation on the abdomen far from the appendix in the left lower quadrant (LLQ) as in most people the appendix is in the right lower quadrant. While this maneuver stretches the entire peritoneal lining, it only causes pain in any location where the peritoneum is irritating the muscle. In the case of appendicitis, the pain is felt in the right lower quadrant despite pressure being placed elsewhere. If left lower quadrant pressure by the examiner leads only to left-sided pain or pain on both the left and right sides, then there may be some other pathologic etiology. This may include causes relating to the bladder, uterus, descending (left) colon, fallopian tubes, ovaries, or other structures. The maneuver is said to named after a Danish surgeon, Niel Thorkild Rovsing Kimpel.