Physicians use a variety of patient manipulations in the exam room to confirm suspected diagnoses so they can initiate a treatment plan as quickly as possible. A test called the obturator sign test is often done when appendicitis is the culprit, which is the case in about 7 percent of the population in their lifetimes. This involves the clinician manipulating the right leg inward to slightly compress the pelvic region. Pain during this movement will indicate that a patient may have an inflamed appendix, which is a seemingly useless little bulge that is attached to the lower small intestine.
Before a doctor confirms appendicitis via x-ray and recommends surgical excision, the obturator sign test helps isolate damage. With the patient lying supine, the clinician will flex the patient's right leg by bending the knee. The doctor will then bring your knee up to your chest and rotate it toward your belly button. The patient is then asked to indicate whether the pain intensifies during the obturator sign test.
Other common tests are used in concert with the obturator sign to fully confirm a clinical diagnosis of appendicitis. Some also lightly press on the patient's McBurney point, which is located three-quarters of the way from the patient's navel to the hip. This is the approximate location of the appendix. Another test, called the Psoas sign test, has the patient's right leg in a straight position, with pressure applied to the top of the knee. When the patient tries to raise the knee, the stabbing pain will be one more indication of appendicitis.
Acute appendicitis often rears its head with pain that radiates from the navel to where the appendix joins the small intestine, near the right pelvic joint. Other symptoms may also occur, from fever and nausea to vomiting and loss of appetite. However, the main sign is abdominal pain that cannot be ignored, particularly when coughing or moving the right pelvic joint, which is the basic purpose of an obturator sign examination. If left untreated, the appendix could rupture painfully, causing an immediate risk of developing peritonitis, which is an internal infection that is immediately life-threatening.
The appendix remains a mysterious phenomenon as of 2011. Medical experts still don't quite know why it exists, as removing it doesn't seem to have a marked effect on the patient. According to the American Academy of Family Physicians, the condition is the most common reason a person needs surgery on the abdomen, most often occurring in people between the ages of 10 and 30. Appendicitis is usually caused by various bacterial infections.