The psoas sign, also known as Cope's sign (or Cope's psoas test[1]) or Obraztsova's sign,[2] is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
The technique for detecting the psoas sign is carried out on the patient's right leg. The patient lies on his/her left side with the knees extended. The examiner holds the patient's right thigh and passively extends the hip. Alternatively, the patient lies on their back, and the examiner asks the patient to actively flex the right hip against the examiner's hand.[3]
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 appendix when the patient is 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 vessel.
It was introduced by Zachary Cope (1881–1974), an English surgeon.[4][5]
^Bhat, Sriram; M, Sriram Bhat (30 December 2012). SRB's Manual of Surgery. JP Medical Ltd. p. 1279. ISBN 978-93-5025-944-3.
^Augustin, Goran (12 May 2014). Acute Abdomen During Pregnancy. Springer. p. 8. ISBN 978-3-319-05422-3.
^Bickley, Lynn S. Bates' Guide to Physical Exam and History Taking (9th ed.). Lippincott, Williams, and Wilkins. p. 390.
^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.
^Silen, William (revised by) (2005). Cope's early diagnosis of the acute abdomen (21st ed.). Oxford: Oxford University Press. ISBN 0-19-517545-X.
The psoassign, also known as Cope's sign (or Cope's psoas test) or Obraztsova's sign, is a medical sign that indicates irritation to the iliopsoas group...
Psoas /ˈsoʊ.æs/ (from Greek ψόας) can refer to: Psoas major muscle Psoas minor muscle Psoassign This disambiguation page lists articles associated with...
appendix. The principles of the obturator sign in the diagnosis of appendicitis are similar to that of the psoassign. The appendix is commonly located in...
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lesser trochanter of the femur. The psoas minor, only present in about 50 per cent of subjects, originates above the psoas major to stretch obliquely down...
catheterization or for interventional radiology, and the administration of a psoas compartment nerve block. As well as initial symptoms, the accumulation of...
limited hip turn out (which is essential to dances such as ballet). Weak psoas (short for iliopsoas-muscle that controls the hip flexor) forces the dancer...
adjacently situated infected foci, such as from the fallopian tubes, adnexa, psoas abscess or secondary tuberculous spondylitis. It can also spread from infected...
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alae (wings) articulate with the sacroiliac joints. The alae support the psoas major muscles and the lumbosacral trunk which connects the lumbar plexus...
peritoneal cavity, evidence of ileus or obstruction and obliteration of the psoas shadow. Diagnostic ultrasound, gallium and CT scanning may detect appendiceal...
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called the urogenital sinus and clitoral sheath respectively. Vulva hand sign used as a yogic mudra Attic red-figure lid depicting three vulvae and a winged...
pelvis. They proceed anterior and inferior along the medial border of the psoas major muscles. They exit the pelvic girdle posterior and inferior to the...
iliotibial tract (see "iliotibial band syndrome") and hip flexors, including the psoas muscle. Individuals with severe and long-standing sacroiliac joint dysfunction...
major blood vessels. The target injection site would be anteromedial to the psoas muscle and dorsolateral to the abdominal aorta, where the sympathetic trunk...
can also be caused by diseases of the organs in the abdomen (such as a psoas abscess) or by testicular disease. Rarely, there is an underlying rheumatic...
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