What condition is highly suggested by a positive psoas and obturator sign?

A positive psoas sign and obturator sign are clinical assessments that indicate irritation or inflammation of the structures in the pelvic and abdominal regions, most commonly associated with appendicitis.

The psoas sign is performed by extending the hip while the patient is lying on their back, which stretches the psoas muscle. Pain during this maneuver can indicate an inflamed appendix that is adjacent to the psoas muscle. Similarly, the obturator sign involves flexing the hip and knee and internally rotating the hip, which can cause pain if there is irritation of the obturator internus muscle, often due to an inflamed appendix.

Acute appendicitis is characterized by inflammation of the appendix, typically presenting with abdominal pain, fever, and nausea. The location of the appendix and its relationship to the psoas and obturator muscles explains why the signs are particularly associated with this condition.

Other conditions such as ectopic pregnancy and peritonitis, while potentially causing abdominal pain, do not specifically elicit a positive psoas or obturator sign in the same way as appendicitis does. An abdominal aortic aneurysm would also generally present with different clinical findings, such as back pain or a pulsatile mass in the abdomen