Citation, DOI & article data
Rovsing sign is commonly used to describe pain elicited in the right iliac fossa on deep palpation of the left iliac fossa.
It is used in clinical examination to detect peritoneal irritation in the right iliac fossa, most frequently associated with acute appendicitis. Most teaching erroneously describes the sign as elicited by deep palpation or percussion in the left iliac fossa 3. However the sign as described by Rovsing described sliding the hand cranially from the left iliac fossa to push descending colon contents back towards the cecum, distending it and causing right lower quadrant pain 1,3.
A meta-analysis of the usefulness of history, examination findings, blood tests and POCUS in pediatric acute appendicitis presenting to an emergency department found that Rovsing sign was the physical sign correlating best with acute appendicitis (likelihood ratio (LR) 3.52, CI 2.65-4.68). Although this is for the "erroneous" sign (see above) 2.
History and etymology
Niels Thorkild Rovsing (1862-1927), a Danish surgeon, first described the sign in 1907 1,3,4.
- 1. Hognason K & Swan K. Niels Thorkild Rovsing: The Surgeon Behind the Sign. Am Surg. 2014;80(12):1201-6. - Pubmed
- 2. Benabbas R, Hanna M, Shah J, Sinert R. Diagnostic Accuracy of History, Physical Examination, Laboratory Tests, and Point-Of-Care Ultrasound for Pediatric Acute Appendicitis in the Emergency Department: A Systematic Review and Meta-Analysis. Acad Emerg Med. 2017;24(5):523-51. doi:10.1111/acem.13181 - Pubmed
- 3. Prosenz J & Hirtler L. Rovsing Sign Revisited-Effects of an Erroneous Translation on Medical Teaching and Research. J Surg Educ. 2014;71(5):738-42. doi:10.1016/j.jsurg.2014.03.002 - Pubmed
- 4. Rovsing T. Indirektes Hervorrufen des typischen Schmerzes an McBurney’s Punkt. Ein Beitrag zur Diagnostik der appendicitis und typhlitis. Zentralbl Chir. 1907;34(43):1257-1259.