Acute or chronic abdominal pain and tenderness of referred origin, from spinal or sacro-iliac strain, often so closely simulates that due to intra-abdominal disorder that the differentiation taxes the skill of the diagnostician.
Orthopedists have for years called attention to this association of abdominal pain arising reflexly from spinal and sacro-iliac lesions.
A thorough investigation of the subject by Carnett1 in the past few years has not only accentuated this knowledge but definitely shown the relationship between certain types of abdominal pain and tenderness, clearly the result of skin hyperesthesia, due to nerve transmission from the abdominal parietes, explaining many operative failures in correcting abdominal pain of long standing. He has also devised several important tests that are helpful in differentiating abdominal pain reflexly of parietal origin.
Recently a helpful test devised by Wachs, of vaginal palpation for sacro-iliac strain, has been added to the list.
Two years ago,
RUBENSTONE AI. A SIGN DIFFERENTIATING ABDOMINAL PAIN OF PARIETAL FROM INTRA-ABDOMINAL ORIGIN. JAMA. 1930;95(24):1803–1804. doi:10.1001/jama.1930.02720240013004