Positive or negative psoas maneuver and sign: what it is and what it indicates
The psoas maneuver is a maneuver used in medical semiotics to investigate the presence of abdominal pain. Its positivity indicates acute appendicitis
How to perform the psoas maneuver
- the patient is lying down and supine (belly up);
- the doctor, with the fingers and the palm of the hand, exerts pressure on the abdomen at the level of the right iliac fossa;
- at the same time the patient’s limb is lifted, with a stiff knee;
- this maneuver involves the contraction of the psoas muscle which in turn presses on the cecum and on the appendix: in the presence of appendicitis this maneuver causes pain.
What does the positive psoas sign mean?
As just mentioned, the positive psoas sign indicates the probable presence of acute appendicitis.
Is the psoas sign sufficient to make a diagnosis?
No. As often happens in semiotics, the positive psoas sign represents an indication of diagnosis and is NOT sufficient on its own to make any precise diagnosis: in fact, the latter must be investigated by continuing with diagnostic laboratory tests (blood chemistry tests) and diagnostics for images (ultrasound, RX…) which can avoid false positives and negatives.
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