Signs and Evidence

Making clinical sense of scientific data


Murphy's sign

Murphy’s sign is performed by palpating the subcostal region during inspiration. If pain is elicited and the patient suddenly stops their inspiratory effort, a positive Murphy’s sign has been elicited.
Musana K et al. Murphy’s Sign. Clin Med Res. 2005 Aug; 3(3): 132
 Positive likelihood ratio
2.80 ( Trowbridge RL et al. )
5.00 ( Abraham S et al. )
1.24 ( Hwang H et al. )
(average) 3.01
Negative likelihood ratio
0.50 ( Trowbridge RL et al. )
0.40 ( Abraham S et al. )
0.71 ( Hwang H et al. )
(average) 0.54

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