Murphys Sign
Other Names
- Murphy's Sign
- Murphy Sign
- Inspiratory Arrest Sign
- Gallbladder Tenderness Sign
- Sonographic Murphy Sign (when performed with ultrasound probe)
Purpose
- In patients with abdominal pain in the right upper quadrant, evaluate for the presence of acute cholecystitis
Description
- Patient is positioned supine
- Examiner palpates the right upper quadrant at the costal margin (midclavicular line)
- Patient is asked to take a deep inspiration
- Positive test
- Abrupt cessation of inspiration due to pain when the inflamed gallbladder contacts the examiner’s hand
Pathology
- Acute Cholecystitis (most commonly)
- Biliary colic (may be less consistently positive)
- Gallbladder inflammation due to obstruction (e.g., cholelithiasis)
Evidence
- Singer et al[1]
- Sensitivity: 48–65%
- Specificity: 79–96%
- Ralls et al for Sonographic Murphy sign[2]
- Sensitivity: 63–86%
- Specificity: 35–94%
See Also
References
- ↑ Singer AJ, McCracken G, Henry MC, Thode HC Jr, Cabahug CJ. Correlation among clinical, laboratory, and hepatobiliary scanning findings in patients with suspected acute cholecystitis. Ann Emerg Med. 1996.
- ↑ Ralls PW, Colletti PM, Lapin SA, Chandrasoma P, Boswell WD Jr, Ngo C. Real-time sonography in suspected acute cholecystitis: prospective evaluation of primary and secondary signs. Radiology. 1985.
Created by:
John Kiel on 5 April 2026 23:05:17
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Last edited:
5 April 2026 23:56:21
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