A positive Massouh sign is a grimace of the person being examined upon a right sided (and not left) sweep. Obturator sign: The person being evaluated lies on her or his back with the hip and knee both flexed at ninety degrees. The examiner holds the persons ankle with one hand and knee with the other hand. The examiner rotates the hip by moving the persons ankle away from his or her body while allowing the knee to move only inward. A positive test is pain with internal rotation of the hip. Psoas sign, also known as "Obraztsovas sign", is right lower-quadrant pain that is produced with either the passive extension of the right hip or by the active flexion of the persons right hip while supine. The pain that is elicited is due to inflammation of the peritoneum overlying the iliopsoas muscles and inflammation of the psoas muscles themselves. Straightening out the leg causes pain because it stretches these muscles, while flexing the hip activates the iliopsoas and causes pain. Rovsings sign: Pain in the lower right abdominal quadrant with continuous deep palpation starting from the left iliac fossa upwards (counterclockwise along the colon). The thought is there will be increased pressure around the appendix by pushing bowel contents and air toward the ileocaecal valve provoking right-sided abdominal pain. Sitkovskiy (Rosenstein)s sign: Increased pain in the right iliac region as the person is being examined lies on their left side.
Ovarian remnant syndrome is a condition that occurs when ovarian tissue is left behind following oophorectomy, causing development of a pelvic mass, pelvic pain, and occasionally dyspareunia. Ovarian remnant syndrome (ORS) is characterized by the presence of residual ovarian tissue after a woman has had surgery to remove one ovary or both ovaries (oophorectomy). Signs and symptoms
If ovarian hormones are present after the ovaries are removed can be a sign that ovarian tissue still remains. Signs and symptoms may include pelvic pain, a pelvic mass, or the absence of menopause after oophorectomy. Factors may include pelvic adhesions (limiting ability to see the ovary or causing it to adhere to other tissues); anatomic variations; bleeding during surgery; or poor surgical technique. Treatment is indicated for people with symptoms and typically involves surgery to remove the residual tissue. Therapy for those who refuse surgery, cannot have surgery, or do not have a pelvic mass may include hormonal therapy to suppress ovarian function.Some women have symptoms consistent with endometriosis, including difficult or painful intercourse; urinary symptoms; or bowel symptoms. It is likely that some women with ORS dont have any symptoms, but the rate of this is unknown. In most cases, symptoms occur within the first five years of the oophorectomy, although there are reports of ORS presenting 20 years after the initial surgery. Cause
The cause of ORS is the unintentional retention of ovarian tissue after the procedure to remove the ovaries. If a woman is receiving hormone replacement therapy, distinguishing from other disease process may be difficult.