A patient with abdominal pain and fever is suspected to have acute appendicitis. What does Rovsing's sign indicate?

Rovsing's sign is a clinical indicator used in the diagnosis of acute appendicitis. It is elicited when palpation of the left lower quadrant of the abdomen causes pain in the right lower quadrant. This occurs due to the shared peritoneal irritation from the inflamed appendix, which causes referred pain.

When a healthcare provider palpates the left side, they may push against the intestines and other structures that share nerve supply with the appendix, leading to pain being felt on the opposite side where the appendix is inflamed. This response helps clinicians confirm suspicion of appendicitis, as the presence of Rovsing's sign suggests that the condition may involve inflammation of the appendix.

The other choices do not accurately describe Rovsing's sign. Pain experienced in the right lower quadrant during direct palpation there suggests localized peritoneal irritation but does not involve the left side as indicated by Rovsing's sign. Severe nausea when standing relates more to issues of orthostatic hypotension or vestibular dysfunction rather than appendicitis. Similarly, pain relief when sitting does not correlate with the typical presentation or assessment findings for appendicitis.