Diagnostic value of the jumping-up test in children with suspected acute appendicitis.

Abstract

Background: Diagnosing acute appendicitis in children is often difficult due to non-specific symptoms and limited cooperation during physical examination. This study aimed to evaluate the diagnostic utility of the Jumping-Up (J-Up) test, and to compare it with traditional physical signs.

Methods: We conducted a prospective observational study from September 2021 to July 2023 in the pediatric emergency department of Asan Medical Center Children's Hospital in Seoul, Korea. Children aged 6-17 years with suspected appendicitis were enrolled. The J-Up test involved instructing patients to jump with both arms raised; the pain response during landing was then assessed. A positive result was defined by visible signs of pain, such as facial grimacing, abdominal guarding, or verbal complaints. Diagnosis was confirmed by contrast-enhanced abdominal CT. The sensitivity of the J-Up test was compared with the sensitivities of rebound tenderness, psoas sign, obturator sign, and Rovsing's sign.

Results: Of the 129 children included, 76 were diagnosed with appendicitis. Mean age was 11.7 ± 3 years and 54.3% (n = 70) were male. The J-Up test was more sensitive (80.3%) than rebound tenderness (69.7%). In complicated cases of appendicitis, the J-Up test had a sensitivity of 92.9%, outperforming the other signs.

Conclusion: The Jumping-Up test is a simple and effective tool for diagnosing appendicitis in children, especially in identifying complicated cases. It may serve as a practical adjunct to traditional methods of physical examination in pediatric emergency care.