Wednesday, April 21, 2021

"sonographic Murphy's sign"

 Q: A "sonographic Murphy's sign" is more reliable than a manual Murphy's sign? 

A) True 

B) False

Answer: A

Positive murphy's sign is considered a hallmark in the diagnosis of acute cholecystitis. It is considered positive if during deep palpation of the right upper quadrant (RUQ) patient is asked to take a deep breath and if he/she abruptly holds the breath due to the severity of pain.

A similar response can be elicited from the transducer (probe) during RUQ ultrasound. It is found to be more accurate and reliable than conventional Murphy's sign, as stone and bile duct can be visualized at the same time, and correlation can be established. 

Historical trivia: Murphy's sign is named after an American surgeon John Benjamin Murphy (1857–1916) who was simultaneously a general, orthopedics, neuro, and cardiothoracic surgeon.



1. Kiewiet JJ, Leeuwenburgh MM, Bipat S et-al. A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology. 2012;264 (3): 708-20. doi:10.1148/radiol.12111561 

2.  Jackson PG, Evans SRT. 2017. Sabiston Textbook of Surgery. 20th ed. New York (NY). Chapter 54, The biliary system, p.1482-1519. 

3. Musana K, Yale SH. John Benjamin Murphy (1857 - 1916). (2005) Clinical medicine & research. 3 (2): 110-2

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