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Murphy s sign has a sensitivity of 63 86 for diagnosing acute cholecystitis making it a useful but imperfect clinical

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When both teams examined for Murphy s sign the result differed in 24 of cases For general surgery Murphy s sign

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The sensitivity of Murphy s sign is relatively low which means that a negative result does not necessarily rule out

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Tokyo Guideline 2018 states Murphy s sign is not sensitive citing a single center study with sensitivity of only 20 5 1

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Key fact Murphy s sign is highly specific for acute cholecystitis 80 95 but its sensitivity is moderate 60 80 A

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When a positive sonographic Murphy s sign is used in conjunction with the presence of gallstones it has a positive predictive value

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Typically it is positive in cholecystitis but negative in choledocholithiasis pyelonephritis and ascending cholangitis

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SIGNS OF CHOLECYSTITIS MURPHY S SIGN Elicitation Palpate the right subcostal area while the patient inspires deeply Positive

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However a systematic review and an evi dence based review of physical diagnosis stated the con trary with sensitivity ranging