Classic signs of appendicitis are Right lower quadrant direct and rebound tenderness located at the McBurney point (junction of the middle and outer thirds of the line joining the umbilicus to the anterior superior iliac spine) Additional appendicitis signs are pain felt in the right lower quadrant with palpation of the left lower quadrant (Rovsing sign), an increase in pain caused by passive extension of the right hip joint that stretches the iliopsoas muscle (psoas sign), or pain caused by passive internal rotation of the flexed thigh (obturator sign).