Which sign is obtained by internal rotation of the flexed right thigh and can indicate appendicitis?

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The sign created by internal rotation of the flexed right thigh is the obturator sign. When the right thigh is flexed at the knee and hip and the leg is rotated internally, irritation of the obturator nerve by an inflamed appendix—often when the appendix is located near the pelvis—produces pain in the right lower quadrant. This maneuver helps distinguish pelvic or retrocecal involvement of appendicitis from other causes of abdominal pain.

For contrast, the psoas sign involves pain with extension of the right hip (or resisted hip flexion) and points to retrocecal or retroperitoneal irritation. Rovsing’s sign is pain in the right lower quadrant when the left lower quadrant is palpated, reflecting generalized peritoneal irritation. Murphy’s sign is an inspiratory arrest with palpation of the right upper quadrant, indicating cholecystitis, not appendicitis.