Sign of Murphy
In Medicine, the sign of Murphy is a clinical sign which can be identified with the physical Examen or with the echography. It is useful for the differential Diagnostic of the abdominal pains of the quadrant higher right. It is typically positive in the Cholécystite and negative in the Cholangite and the Cholédocolithiases. This sign has good a specificity and sensitivity but its reliability decreases in the elderly.
During the physical examination
To evaluate the sign of Murphy , the Doctor palpus deeply under the costal edge right to the level of the line mid-claviculaire. He then asks the patient to take a major inspiration. The test is positive if the pain with the site of palpation prevents the patient from finishing his inspiration. This pain is due in contact with the Gall bladder sensitive with the fingers of the doctor when it is thorough downwards by the descent of the diaphragm at the time of the major inspiration.
At the time of echography
At the time of echography, the technique is similar but the fingers of the doctor are replaced by the echographic probe. Echography makes it possible to confirm that the probe is placed on the level of the gall bladder.
References
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