Which of the following is consistent with a positive obturator sign?

A. Pain distant from the site used to check rebound tenderness is incorrect because this describes referred pain or peritoneal irritation, but not the obturator sign specifically. The obturator sign is localized to the hypogastric or pelvic region. B. Right hypogastric pain with the right hip flexed and the hip internally rotated is correct because the obturator sign is elicited by flexing the patient’s hip and knee at 90° and then internally rotating the hip. Pain in the right hypogastric or pelvic area indicates irritation of the obturator internus muscle, often due to an inflamed appendix in a pelvic position or other pelvic pathology. This is a classic sign in appendicitis when the appendix is located in the pelvis. C. Pain with extension of the right thigh while the patient is on their left side is incorrect because this describes the psoas sign, which tests for irritation of the iliopsoas muscle and is also used to detect appendicitis, but specifically for a retrocecal appendix. D. Pain that stops inhalation in the right upper quadrant is incorrect because this describes Murphy’s sign, which is indicative of cholecystitis, not appendiceal or pelvic irritation.