Mr. Keenan had an appendectomy at age 11. However in a different patient, recalling that occasionally appendicitis presents outside of the traditional RLQ area, what additional physical examination techniques might you perform to assess for appendicitis?

 No costovertebral angle (CVA) tenderness.
You exit the exam room to discuss the case with Dr. Hill. Then both of you return to Mr. Keenan’s room, and she confirms your interview and physical exam.
Question
Mr. Keenan had an appendectomy at age 11. However in a different patient, recalling that occasionally appendicitis presents outside of the traditional RLQ area, what additional physical examination techniques might you perform to assess for appendicitis?