Where does the pain of appendicitis usually localize after beginning in the RUQ?

The pain of appendicitis typically starts in the right upper quadrant (RUQ) but then migrates to the right lower quadrant (RLQ) as the condition progresses. This pattern of pain localization is due to the irritation of the peritoneum as the inflammation of the appendix worsens. The appendix is located in the RLQ, so as the inflammation increases, the pain becomes more pronounced in this area.

The journey from the RUQ to the RLQ is a classic sign of appendicitis and is important for both diagnosis and management. The pain often radiates or migrates and may initially present as generalized abdominal pain before it localizes. This specific pattern is a key clinical indicator that healthcare providers look for when assessing a patient for appendicitis.

In addition, the other areas mentioned—such as the LLQ, epigastric region, and lower back—are less likely to be associated with appendicitis. The LLQ might be involved in other conditions, the epigastric region is more commonly related to gastric issues, and lower back pain is not characteristic for appendicitis specifically. Understanding the classic migration of pain to the RLQ is essential in recognizing and diagnosing this acute surgical emergency.