Cheers for Murphy's sign

Even though Murphy's sign is nonspecific, I use it to aid in diagnosing gallbladder disease in patients with a history of fatty meals leading to abdominal pain. If a hand placed in the medial aspect of the upper right quadrant and a command to take a deep breath elicits pain, I do a hepato-iminodiacetic acid scan with ejection fraction. A positive sign has been about 90% accurate in diagnosing gallbladder pathology.
—Edgar R. Marr, MD, Avon, Ohio (123-16)
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