Which physical examination sign indicates appendicitis when pain is elicited by extending the right thigh?

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Extending the right thigh tests the iliopsoas muscle. If the appendix is irritated and lies near the psoas (often retrocecal), lengthening and stretching the psoas during thigh extension irritates the inflamed tissue, producing pain. This is called the psoas sign and points toward appendicitis.

Other signs help differentiate: Rovsing's sign is pain in the right lower quadrant when the left lower quadrant is palpated, reflecting peritoneal irritation rather than a specific muscle: nerve relationship. Obturator sign involves internal rotation of a flexed right hip and indicates irritation of the obturator nerve/pelvic appendix. Murphy's sign is associated with gallbladder inflammation and is tested with deep inspiration during RUQ palpation, not related to the psoas muscle or appendix.