Signs and Evidence

Making clinical sense of scientific data


Beware of the limitations of this tool


Calculated pretest probability: 5 %
Relevant inclusion criteria: Acute abdominal pain 



Clinical signs

6Murphy's sign
7Rebound tenderness
8Right upper quadrant pain

To further investigations

Sources used:

1.Trowbridge RL et al. Does This Patient Have Acute Cholecystitis? JAMA, January 1, 2003—Vol 289, No. 1 80-86
2.Abraham S et al. Surgical and Nonsurgical Management of Gallstones. Am Fam Physician. 2014 May 15;89(10):795-802
3.Hwang H et al. Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital. Can J Surg. 2014 Jun; 57(3): 162–168
4.Kiewiet JJS et al. A Systematic Review and Meta-Analysis of Diagnostic Performance of Imaging in Acute Cholecystitis. Radiology September 2012 Volume 264, Issue 3
5.Klugsberger B et al. Clinical Value of Sonography and CT-Scan in the Diagnosis of Acute Cholecystitis: A Retrospective Analysis. Ann Emerg Surg 2(3): 1021 (2017)
6.Kumar K et al. To study the sensitivity and specificity of Ultrasonography for diagnosing cholelithiasis in a tertiary care teaching hospital Int J Med Res Prof.2015;1(3); 64-67
7.Shea JA et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med. 1994;154(22):2573–2581