What Is the Utility of the Murphy’s Sign and Does It Change with Pain Medication?

Abstract

Murphy’s sign occurs when a patient feels pain as the right upper quadrant is palpated under the costal margin during inspiration, resulting in inspiratory arrest. This maneuver is supposed to compress the gallbladder, and, thus, pain would suggest acute inflammation of the gallbladder. A positive Murphy’s sign increases the likelihood that the patient has cholecystitis, and a negative Murphy’s sign makes it less likely, but the finding lacks the sensitivity and specificity to rule in or rule out acute cholecystitis. The sonographic Murphy’s sign occurs when pain is caused by compression of the gallbladder under sonographic visualization. It is more accurate than a simple Murphy’s sign for diagnosing cholecystitis. Neither Murphy’s sign is affected by analgesic administration.