Murphy Sign

Aka: Murphy Sign

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II. Indications

  1. Acute Cholecystitis

III. Technique

  1. Examiner palpates the abdominal RUQ (deep subcostal palpation)
  2. Patient takes a deep breath

IV. Interpretation

  1. Positive test if the patient has increased pain or suddenly halts their inspiration due to pain (inspiratory arrest)
  2. Suggests Acute Cholecystitis when present

V. Efficacy

  1. General patients
    1. Positive Likelihood Ratio: 5.0
    2. Negative Likelihood Ratio: 0.4
    3. Test Sensitivity: 65%
    4. Test Specificity: 87%
  2. Older patients
    1. Positive Likelihood Ratio: 2.3
    2. Negative Likelihood Ratio: 0.66
    3. Test Sensitivity: 48%
    4. Test Specificity: 79%

VI. References

  1. Trowbridge (2003) JAMA 289(1): 80-6 [PubMed]

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