Sonographic Murphy sign

Last revised by Angela Liao on 24 May 2023

Sonographic Murphy sign is defined as maximal abdominal tenderness from the pressure of the ultrasound probe over the visualized gallbladder 1,2. It is a sign of local inflammation around the gallbladder along with right upper quadrant pain, tenderness, and/or a mass 2.

It is one of the most important sonographic signs of cholecystitis and when combined with the presence or absence of cholelithiasis it has a high positive and negative predictive value respectively 3.

The sonographic Murphy sign is the radiological correlate of the clinical Murphy sign, which is elicited by deep palpation of the right hypochondrium followed by the examiner asking the patient to inspire. If the patient's breath abruptly stops, then it is a positive Murphy sign 5,6.

History and etymology

John Benjamin Murphy (1857–1916), was an American surgeon, regarded by his peers as a surgeon without equal, in view of his mastery of general surgery, orthopedics, neurosurgery and cardiothoracic surgery. He is best remembered for his eponymous sign 4,5.

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