Editing Appendicitis (section)

===Signs===
During the early stages of appendicitis diagnosis, it is common for [[Physical examination|physical exams]] to present inconspicuous findings. Signs of inflammation become noticeable as the disease progresses. These signs may include<ref>Jones MW, Lopez RA, Deppen JG. Appendicitis. [Updated 2023 April 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493193/</ref>
* [[Aure-Rozanova's sign]]: Increased pain on palpation with a finger in the right [[Lumbar triangle|inferior lumbar triangle]] (can be a positive [[Blumberg's sign]]).<ref name="SachdevaDutta2012">{{cite book|last1=Sachdeva|first1=Anupam|last2=Dutta|first2=AK|title=Advances in Pediatrics|date= 2012|publisher=JP Medical |isbn=978-93-5025-777-7|page = 1432}}</ref>
* [[Bartomier-Michelson's sign]]: Increased pain on palpation at the right iliac region as the person being examined lies on their left side compared to when they lie on their back.<ref name="SachdevaDutta2012"/>
* [[Dunphy's sign]]: Increased pain in the right lower quadrant by coughing.<ref name=Sign>{{cite book |last1=Al-Salem |first1=Ahmed H. |title=Atlas of Pediatric Surgery: Principles and Treatment |date=2020 |publisher=Springer |location=Cham |isbn=978-3-030-29210-2 |edition=1st }}</ref>
* [[Hamburger sign]]: The patient refuses to eat ([[anorexia (symptom)|anorexia]] is 80% [[Sensitivity and specificity|sensitive]] for appendicitis)<ref name="VirgilioFrank2015">{{cite book|last1=Virgilio|first1=Christian de|last2=Frank|first2=Paul N.|last3=Grigorian|first3=Areg|title=Surgery|date= 2015|publisher=Springer|language=en |isbn=978-1-4939-1726-6|page = 215}}</ref>
* [[Kocher's sign (appendicitis)|Kocher's sign]] (Kosher's sign): From the person's medical history, the start of pain in the umbilical region with a subsequent shift to the right iliac region.<ref name="SachdevaDutta2012"/>
* [[Massouh's sign]]: Developed in and popular in southwest England, the examiner performs a firm swish with their index and middle finger across the abdomen from the [[xiphoid process]] to the left and the right iliac fossa.<ref name="Sign"/>
* [[Obturator sign]]: The person being evaluated lies on her or his back with the hip and knee both flexed at ninety degrees. The examiner holds the person's ankle with one hand and knee with the other hand. The examiner rotates the hip by moving the person's ankle away from their body while allowing the knee to move only inward. A positive test is pain with internal rotation of the hip.<ref name="WolfsonCloutier2014">{{cite book|last1=Wolfson|first1=Allan B.|last2=Cloutier|first2=Robert L.|last3=Hendey|first3=Gregory W.|first4=Louis J.|last4=Ling|first5=Jeffrey J.|last5=Schaider|first6=Carlo L.|last6=Rosen|title=Harwood-Nuss' Clinical Practice of Emergency Medicine|url=https://books.google.com/books?id=cgMYBQAAQBAJ&pg=PT5810|access-date=15 June 2016|date= 2014|publisher=Wolters Kluwer Health|language=en|isbn=978-1-4698-8948-1|page = 5810|quote=Physical signs classically associated with acute appendicitis include Rovsing sign, psoas sign, and obturator sign.|url-status=live|archive-url=https://web.archive.org/web/20170910171627/https://books.google.com/books?id=cgMYBQAAQBAJ&pg=PT5810|archive-date=10 September 2017}}</ref>
* [[Psoas sign]], also known as "Obraztsova's sign", is right lower-quadrant pain that is produced with either the passive extension of the right hip or by the active flexion of the person's right hip while supine. The pain that is elicited is due to inflammation of the peritoneum overlying the iliopsoas muscles and inflammation of the psoas muscles themselves. Straightening out the leg causes pain because it stretches these muscles while flexing the hip activates the iliopsoas and causes pain.<ref name="WolfsonCloutier2014"/>
* [[Rovsing's sign]]: Pain in the lower right abdominal quadrant with continuous deep palpation starting from the left [[iliac fossa]] upwards (counterclockwise along the colon). The thought is there will be increased pressure around the appendix by pushing bowel contents and air toward the [[ileocaecal valve]] provoking right-sided abdominal pain.<ref>{{cite journal |last=Rovsing |first=N.T. |date=1907 |title=Indirektes Hervorrufen des typischen Schmerzes an McBurney's Punkt. Ein Beitrag zur diagnostik der Appendicitis und Typhlitis |journal=Zentralblatt für Chirurgie |location=Leipzig |volume=34 |pages=1257–1259|language=de}}</ref>
* [[Rosenstein's sign]] (Sitkovsky's sign): Increased pain in the right iliac region as the person is being examined lies on their left side.<ref name="DunsterHunter1922">{{cite book|last1=Dunster|first1=Edward Swift|last2=Hunter|first2=James Bradbridge|last3=Sajous|first3=Charles Euchariste de Medicis|first4=Frank Pierce |last4=Foster |first5=Gregory |last5=Stragnell |first6=Henry J. |last6=Klaunberg |first7=Félix |last7=Martí-Ibáñez |title=International Record of Medicine and General Practice Clinics|year=1922|publisher=New York Medical Journal |language=en|pages = 663}}</ref>
* Perman's sign: In acute appendicitis palpation in the left iliac fossa may produce pain in the right iliac fossa.<ref>Emil Samuel Perman (1856–1946), "About the indications for surgery in appendicitis and an account of cases of Sabbatsberg Hospital in Hygiea, 1904.</ref>