Family Nurse Practitioner Exam

A positive obturator sign may signify which condition?

1. Acute appendicitis

2. Acute pancreatitis

3. Acute cholecystitis

4. Acute hepatitis

The correct answer is: Acute appendicitis

The obturator sign is a clinical test used to assess for irritation of the obturator internus muscle, which can occur as a result of inflammation in the pelvis, particularly from acute appendicitis. When a patient is lying flat and the right hip is flexed and internally rotated, pain in the right lower quadrant can indicate irritative processes in that area. In the context of acute appendicitis, which typically involves inflammation of the appendix located in the right lower quadrant, a positive obturator sign supports the diagnosis due to the anatomical proximity of the appendix to the obturator muscle. The sign is less relevant for the other conditions listed, as they either do not cause similar muscle irritation or involve different anatomical locations. Therefore, the association of the obturator sign with acute appendicitis makes it the correct answer.