Obturator sign

The obturator internus and nearby muscles

A coronal section of the pelvis illustrating the proximity of the obturator internus to the abdominopelvic viscera.

The obturator sign, also known as the Cope sign,^{[citation needed]} is an indicator of irritation to the obturator internus muscle. ^[1]

The technique is carried out on each leg in succession. First the patient lies on his back with the right hip flexed at 90 degrees. The examiner then holds the patient's right ankle in his right hand. With his left hand, the examiner rotates the hip by moving the right knee inward. This is flexion and internal rotation of the hip.

In the clinical context, it is performed when acute appendicitis is suspected. In this condition, the appendix becomes inflamed and enlarged. The appendix may come into physical contact with the obturator internus muscle, which will be stretched when this maneuver is performed on the right leg. This causes pain and is an evidence in support of an inflamed appendix.

The principles of the obturator sign in the diagnosis of appendicitis are similar to that of the psoas sign.

Evidence shows that the Obturator Test does not adequately diagnose appendicitis. (McGee 2007).

See also

• Abdominal exam
• McBurney's point
• Psoas sign
• Rovsing's sign

References

1. ^ Allan B Wolfson (1 September 2009). Harwood-Nuss' Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins. pp. 1222–. ISBN 9780781789431. http://books.google.com/books?id=Idb0Z658lFQC&pg=PT1222. Retrieved 30 May 2011. 

Reference: McGee, S. (2007). Evidence based physical diagnosis (2nd ed.). Philadelphia: Saunders.

External links

• Acute appendicitis review in American Family Physician

Accessory

Hepatosplenomegaly/Hepatomegaly
Jaundice

Abdominopelvic

Ascites

Abdominal – general

Abdominal pain (Acute abdomen, Colic, Baby colic)

Splenomegaly

Abdominal guarding · Abdominal mass · Rebound tenderness

Shifting dullness · Bulging flanks · Puddle sign · Fluid wave test

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