The phenomenon was first described by Swedish surgeon Emil Samuel Perman (1856–1945) writing in the journal Hygiea in 1904.

An appendix with some early inflammation may give a non-specific irritation somewhere near the umbilicus (belly button).

While this maneuver stretches the entire peritoneal lining, it only causes pain in any location where the peritoneum is irritating the muscle.

This may include causes relating to the bladder, uterus, ascending (right) colon, fallopian tubes, ovaries, or other structures.

The eponym Rovsing sign is also used in patients with horseshoe kidney, consisting of abdominal pain, nausea, and vomiting with hyperextension of the spine.