The Murphy’s sign is a physical maneuver that, when combined with an ultrasound finding of an inflamed gallbladder, is used to help differentiate acute cholecystitis from biliary colic.
It is performed by asking the patient to breathe out and hold it, and then breath in while gently pushing upon the abdomen underneath in the subcostal region of the Right Upper Quadrant (RUQ).
In inspiration, the abdominal contents are pushed inferior.
As the inflamed gallbladder comes into contact with the examiner’s hand, the patient winces with sharp pain.
This is considered to be a positive sign for cholecystitis, otherwise known as a positive Murphy’s sign.
This exam maneuver may also be performed in the Left Upper Quadrant (LUQ) for confirmation.
