Clinical features

Dull peri-umbilical pain that later migrates to the right iliac fossa (localised and sharp).

Rebound tenderness of McBurney point, approximately 1.5 to 2 inches from the anterior superior iliac spine (ASIS) 

Nausea and vomiting (typically after the pain),

Specific signs

Specific signs of appendicitis

Rovsing’s sign 

Right iliac fossa pain on palpation of the left iliac fossa

Psoas sign 

Right iliac fossa pain with extension or flexion of the right hip, suggesting a retrocaecal appendix touching the psoas muscle