In a case of retrocecal appendicitis which movement aggravates pain

Hyperextension of the hip joint may induce abdominal pain when the degree of psoas spasm is insufficient to cause flexion of the hip.Rigidity is often absent, and even application of deep pressure may fail to elicit tenderness (silent appendix), the reason being that the caecum, distended with gas, prevents the pressure exeed by the hand from reaching the inflamed structure Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1208