What is the clinical significance of positive Rovsing’s sign during an abdominal exam?

A positive Rovsing’s sign is significant because it is clinically associated with conditions that involve irritation or inflammation in the lower right quadrant of the abdomen, particularly appendicitis. When pressure is applied to the lower left quadrant of the abdomen and this causes pain in the right lower quadrant, it suggests that the inflamed appendix is causing visceral pain that is referred to other areas of the abdomen. This sign is particularly useful in the clinical assessment for appendicitis, as it helps to confirm the diagnosis when the clinical picture may not be entirely definitive.

While other conditions may cause abdominal pain, such as cholecystitis, diverticulitis, or pancreatitis, they have distinct clinical signs and symptoms that are typically evaluated through different physical examination techniques, imaging, or laboratory tests. Therefore, a positive Rovsing’s sign is most specifically indicative of appendicitis, making it a vital point of assessment when evaluating a patient with suspected appendiceal pathology.