Q: What is Boas' sign?
Answer: Boas's sign is hyperaesthesia below the right scapula in acute cholecystitis. It has also been described as 'point tenderness' in the region to the right of the 10th to 12th thoracic vertebrae. Boas' sign can also be present in the stomach and duodenal disease.
The objective of asking this question is that clinical signs in acute cholecystitis can be tricky and no single clinical finding (like the famous Murphy's sign) carries sufficient weight to establish or exclude acute cholecystitis without further testing.
#hepatology
#physical-exam
References:
1. Iyer HV. Boas' sign revisited. Ir J Med Sci. 2011 Mar;180(1):301. doi: 10.1007/s11845-010-0640-x. Epub 2010 Nov 18. PMID: 21086060.
2. Gunn A, Keddie N. Some clinical observations on patients with gallstones. Lancet 1972;2:230-241
3. Trowbridge, RL; Rutkowski, NK; Shojania, KG (1 January 2003). "Does this patient have acute cholecystitis?". JAMA. 289 (1): 80–6.
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