MCQ 22 In a case of retrocecal appendicitis which movement aggravates pain:

A.Flexion
B.Extension
C.Medial rotation
D.Lateral rotation

The correct answer is B.Extension

In retrocecal appendicitis,inflammed appendix is in contact with psoas muscle causing flexion of the hip joint.Hyperextension of the hip joint may induce abdominal pain.

Note:Ascending retrocecal appendicitis presenting with right upper abdominal pain may be clinically indistinguishable from acute pathology in the gallbladder, liver, biliary tree, right kidney and right urinary tract.
Computed tomography (CT) identifies correctly retrocecal appendicitis and inflammation in the retroperitoneum in all cases.

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