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The '''psoas sign''', also known as '''Cope's psoas test'''<ref name="BhatM2012">{{cite book|last1=Bhat|first1=Sriram|last2=M|first2=Sriram Bhat|title=SRB's Manual of Surgery|url=https://books.google.com/books?id=rfUfi_mmbskC&pg=PA1279|date=30 December 2012|publisher=JP Medical Ltd|isbn=978-93-5025-944-3|pages=1279}}</ref> or '''Obraztsova's sign''',<ref name="Augustin2014">{{cite book|last=Augustin|first=Goran|title=Acute Abdomen During Pregnancy|url=https://books.google.com/books?id=mq8pBAAAQBAJ&pg=PA8|date=12 May 2014|publisher=Springer|isbn=978-3-319-05422-3|pages=8}}</ref> is a [[medical sign]] that indicates irritation to the [[iliopsoas group]] of [[hip flexors]] in the [[human abdomen|abdomen]], and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal). It is elicited by performing the ''psoas test'' by passively extending the thigh of a patient lying on his side with knees extended, or asking the patient to flex his thigh at the hip.<ref>{{cite book |last=Bickley |first=Lynn S. |title=Bates' Guide to Physical Exam and History Taking |edition=9th |publisher=Lippincott, Williams, and Wilkins |pages=390}}</ref> If [[abdominal pain]] results, it is a "positive psoas sign". The pain results because the psoas borders the [[peritoneal cavity]], so stretching (by hyperextension at the hip) or contraction (by flexion of the hip) of the muscles causes friction against nearby inflamed tissues. In particular, the right iliopsoas muscle lies under the [[Vermiform appendix|appendix]] when the patient is [[supine position|supine]], so a positive psoas sign on the right may suggest [[appendicitis]]. A positive psoas sign may also be present in a patient with a [[psoas abscess]]. It may also be positive with other sources of [[retroperitoneal]] irritation, e.g. as caused by [[hemorrhage]] of an [[iliac vessels (disambiguation)|iliac vessel]].<!-- intentional dab link or should that become an SIA? -->
The '''psoas sign''', also known as '''Cope's psoas test'''<ref name="BhatM2012">{{cite book|last1=Bhat|first1=Sriram|last2=M|first2=Sriram Bhat|title=SRB's Manual of Surgery|url=https://books.google.com/books?id=rfUfi_mmbskC&pg=PA1279|date=30 December 2012|publisher=JP Medical Ltd|isbn=978-93-5025-944-3|pages=1279}}</ref> or '''Obraztsova's sign''',<ref name="Augustin2014">{{cite book|last=Augustin|first=Goran|title=Acute Abdomen During Pregnancy|url=https://books.google.com/books?id=mq8pBAAAQBAJ&pg=PA8|date=12 May 2014|publisher=Springer|isbn=978-3-319-05422-3|pages=8}}</ref> is a [[medical sign]] that, if positive, can indicate irritation to the [[iliopsoas group]] of [[hip flexors]] in the [[human abdomen|abdomen]].
It is elicited by performing the ''psoas test.'' The examiner passively extends the leg of a patient lying on their side (knees extended) or asks the patient laying in a supine positon to actively raise their extended leg against the examiner's resistance (posteriorly, or toward the exam table) at the thigh.<ref>{{cite book |last=Bickley |first=Lynn S. |title=Bates' Guide to Physical Exam and History Taking |edition=9th |publisher=Lippincott, Williams, and Wilkins |pages=390}}</ref> If increased [[abdominal pain]] results, it is a "positive psoas sign". The pain results because the psoas borders the [[peritoneal cavity]], so stretching (by hyperextension at the hip) or contraction (by flexion of the hip) of the muscles causes friction against nearby inflamed tissues. In particular, the right iliopsoas muscle lies under the [[Vermiform appendix|appendix]] when the patient is [[supine position|supine]], so a positive psoas sign on the right may suggest [[appendicitis]].
In [[Appendicitis|apendicitis]], a positive right psoas sign may also indicate that the inflamed appendix is retrocaecal in orientation (posteriorly), as the iliopsoas muscle is retroperitoneal.
A positive psoas sign may also be present in a patient with a [[psoas abscess]]. The [[differential diagnosis]] includes other sources of [[retroperitoneal]] irritation, such as [[hemorrhage]] of an [[iliac vessels (disambiguation)|iliac vessel]].


It was introduced by [[Zachary Cope]] (1881–1974), an English surgeon.<ref>{{cite journal|last1=Huang|first1=Ih-Ping|last2=Smith|first2=C Daniel|title=Cope's Early Diagnosis of the Acute Abdomen, 21st Edition|journal=Annals of Surgery|date=August 2006|volume=244|issue=2|pages=322|doi=10.1097/01.sla.0000230276.84612.b4|pmc=1602170}}</ref><ref>{{cite book|last1=Silen|first1=William (revised by)|title=Cope's early diagnosis of the acute abdomen.|date=2005|publisher=Oxford University Press|location=Oxford|isbn=0-19-517545-X|edition=21st}}</ref>
It was introduced by [[Zachary Cope]] (1881–1974), an English surgeon.<ref>{{cite journal|last1=Huang|first1=Ih-Ping|last2=Smith|first2=C Daniel|title=Cope's Early Diagnosis of the Acute Abdomen, 21st Edition|journal=Annals of Surgery|date=August 2006|volume=244|issue=2|pages=322|doi=10.1097/01.sla.0000230276.84612.b4|pmc=1602170}}</ref><ref>{{cite book|last1=Silen|first1=William (revised by)|title=Cope's early diagnosis of the acute abdomen.|date=2005|publisher=Oxford University Press|location=Oxford|isbn=0-19-517545-X|edition=21st}}</ref>


== See also ==
== See also ==
{{portal|medicine}}
* [[Abdominal exam]]
* [[Abdominal exam]]
* [[Blumberg sign]]
* [[Blumberg sign]]
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* [[McBurney's point]]
* [[McBurney's point]]
* [[Obturator sign]]
* [[Obturator sign]]
* [[Rovsing's sign]]
* [[Rovsing's sign]]{{portal|medicine}}


== References ==
== References ==
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== External links ==
== External links ==
* [http://www.aafp.org/afp/991101ap/2027.html Acute appendicitis review in American Family Physician]
* [http://www.aafp.org/afp/991101ap/2027.html Acute appendicitis review in American Family Physician]
* [https://www.youtube.com/watch?v=n0a0PCwsVQ4 Video explanation and demonstration of psoas test]


{{Digestive system and abdomen symptoms and signs}}
{{Digestive system and abdomen symptoms and signs}}

Revision as of 23:18, 20 March 2018

The psoas sign, also known as Cope's psoas test[1] or Obraztsova's sign,[2] is a medical sign that, if positive, can indicate irritation to the iliopsoas group of hip flexors in the abdomen.

It is elicited by performing the psoas test. The examiner passively extends the leg of a patient lying on their side (knees extended) or asks the patient laying in a supine positon to actively raise their extended leg against the examiner's resistance (posteriorly, or toward the exam table) at the thigh.[3] If increased abdominal pain results, it is a "positive psoas sign". The pain results because the psoas borders the peritoneal cavity, so stretching (by hyperextension at the hip) or contraction (by flexion of the hip) of the muscles causes friction against nearby inflamed tissues. In particular, the right iliopsoas muscle lies under the appendix when the patient is supine, so a positive psoas sign on the right may suggest appendicitis.

In apendicitis, a positive right psoas sign may also indicate that the inflamed appendix is retrocaecal in orientation (posteriorly), as the iliopsoas muscle is retroperitoneal.

A positive psoas sign may also be present in a patient with a psoas abscess. The differential diagnosis includes other sources of retroperitoneal irritation, such as hemorrhage of an iliac vessel.

It was introduced by Zachary Cope (1881–1974), an English surgeon.[4][5]

See also

  • Abdominal exam
  • Blumberg sign
  • Hamburger sign
  • McBurney's point
  • Obturator sign
  • Rovsing's sign
  • iconmedicine portal

References

  1. ^ Bhat, Sriram; M, Sriram Bhat (30 December 2012). SRB's Manual of Surgery. JP Medical Ltd. p. 1279. ISBN 978-93-5025-944-3.
  2. ^ Augustin, Goran (12 May 2014). Acute Abdomen During Pregnancy. Springer. p. 8. ISBN 978-3-319-05422-3.
  3. ^ Bickley, Lynn S. Bates' Guide to Physical Exam and History Taking (9th ed.). Lippincott, Williams, and Wilkins. p. 390.
  4. ^ Huang, Ih-Ping; Smith, C Daniel (August 2006). "Cope's Early Diagnosis of the Acute Abdomen, 21st Edition". Annals of Surgery. 244 (2): 322. doi:10.1097/01.sla.0000230276.84612.b4. PMC 1602170.
  5. ^ Silen, William (revised by) (2005). Cope's early diagnosis of the acute abdomen (21st ed.). Oxford: Oxford University Press. ISBN 0-19-517545-X.

Template:Eponymous medical signs for digestive system and general abdominal signs

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