What is indicated by pain in the RLQ with appendicitis?

Pain in the right lower quadrant (RLQ) during hip flexion is indicative of appendicitis because this positioning places strain on the psoas muscle, which lies near the appendix. When the appendix is inflamed, movements that stretch or irritate the surrounding structures can reproduce pain in that area, which is often described as the positive psoas sign.

While palpation of the abdomen may lead to discomfort in appendicitis, the key feature here is that hip flexion specifically aggravates the pain due to the anatomical relationships involved. Localized fever and swelling can accompany appendicitis but are not specific indicators of pain; they reflect systemic responses rather than directly pointing to the location of pain. Generalized abdominal pain is also common in various abdominal conditions, making it less specific for diagnosing appendicitis compared to the localized pain with hip flexion. Thus, the response to hip flexion provides key symptomatic insight in the diagnosis of appendicitis, supporting the correctness of the selected option.