The patient lies on a couch. The examiner gently stretches the right
spermatic cord using the thumb and index finger right about the testis in the right scrotum. For a patient with appendicitis, this causes pain in the right
iliac fossa. The traction of spermatic cord is thought to cause right iliac fossa pain due to the apposition of the gonadal vessels against an inflamed appendix. The
sensitivity and
specificity of the Ten Horn's sign is unknown. ==History==