The nurse identifies that the client has a positive Obturator sign. What is the most likely cause of this finding?

A positive Obturator sign indicates pain elicited when the hip is flexed to 90 degrees and then internally rotated, which stretches the obturator internus muscle. This finding is most commonly associated with inflammation in the pelvic region, particularly from an inflamed appendix. Rationale: The Obturator sign is a clinical indicator used in the assessment of appendicitis. It is specifically tested by flexing the client’s right hip and knee to 90 degrees and then rotating the hip internally. Pain during this maneuver suggests irritation of the obturator internus muscle. This muscle lies in close proximity to the pelvic appendix. When the appendix is inflamed, especially if it is positioned in the pelvic cavity, it can come into contact with the obturator internus muscle. The resulting inflammation causes pain during movement that stretches or compresses this muscle. A positive Obturator sign is therefore most commonly seen in cases of pelvic appendicitis rather than classic appendicitis located in the right lower quadrant. It may be accompanied by other signs such as abdominal tenderness, fever, nausea, and rebound tenderness, but its presence specifically suggests a pelvic location of the inflamed appendix. Clinically, this finding supports the diagnosis of acute appendicitis and helps differentiate it from other causes of abdominal pain. The nurse should report the finding promptly, monitor for signs of worsening abdominal condition, and prepare the client for further diagnostic evaluation or possible surgical intervention.