Corpus: Appendicitis sign

The term appendicitis signs refers to specific pain points in the abdomen that occur in appendicitis and aid in its diagnosis. The large number of these signs has emerged due to the varying positions of the appendix and the historically limited availability of diagnostic imaging.

Signs of appendicitis include:

• In the area of Sherren's triangle:
  • Rovsing's sign
  • Blumberg's sign
  • Pain at Morris' point
  • Pain at Kümmell's point
• On the Monro line:
  • Pain at McBurney's point
• On the Lenzmann line:
  • Pain at Lanz-Sonnenburg's point
  • Pain at Lenzmann's point
• Other signs:
  • Aaron's sign
  • Baldwin's sign
  • Baron's sign
  • Ben Asher's sign
  • Brittain's sign
  • Bassler's sign
  • Bastedo's sign
  • Chapman's sign
  • Cope's sign
  • Douglas' sign
  • Dunphy's sign
  • Gray's sign
  • Ligat's sign
  • Przewalski's sign
  • Reder's sign
  • Sattler's sign
  • Sitkowski's sign
  • Ten-Horn's sign
  • Psoas sign
  • Obturator sign

Appendicitis signs should always be assessed in combination with other clinical findings. No single sign is specific enough to definitively diagnose appendicitis. Likewise, the absence of these signs does not completely rule out the condition.

Testing for multiple appendicitis signs does not necessarily increase diagnostic accuracy. A strong clinical suspicion is typically based on just a few key signs, such as rebound tenderness or asymmetry in pain presentation between the right and left side of the abdomen.

Diagnostic accuracy can be further improved by evaluating laboratory markers such as white blood cell count and C-reactive protein (CRP) levels, as well as performing an abdominal ultrasound. If findings remain inconclusive or if examination is challenging (e.g., in obese patients), a computed tomography (CT) scan can be used to confirm the diagnosis.