Clinical PodcastsPaediatrics

Is missing appendicitis standard of care?

…..In children it may be.

Which of these signs in the clinical examination of a child with suspected appendicitis have the highest positive likelihood ratio?
Put them in order.

  • Rebound Tenderness
  • Rovsings Sign
  • Obturator Sign
  • Guarding
  • Right Lower Quadrant Pain

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Positive Likelihood Ratios Shown from Highest to Lowest

  • Rovsings Sign (3.5)  OR Obturator Sign (3.5)
  • Rebound Tenderness (2.2)
  • Guarding (2.1)
  • Right Lower Quadrant Pain (1.4)

In fact Rovsing Sign and Obturator Sign have the highest LR with the Obturator Sign following with a LR of 3.2.

Listen to the podcast below and follow with the shownotes as we look at Appendicitis, Messenteric Adenitis and Viral illness causing abdominal pain and how to differentiate them.

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Clinical Podcasts Paediatrics Published on: 07/02/2025