Sonographic Murphy’s sign

The Sonographic Murphy’s sign is a key diagnostic finding in abdominal ultrasound, specifically indicating acute cholecystitis, or gallbladder inflammation. It is elicited when localized pain is reported by the patient upon direct pressure from the ultrasound probe over the visualized gallbladder. This sign helps differentiate acute cholecystitis from other causes of right upper quadrant pain.

This clinical maneuver, performed under real-time ultrasound guidance, significantly enhances diagnostic accuracy. Its presence, coupled with other sonographic findings like gallbladder wall thickening or pericholecystic fluid, strongly suggests acute cholecystitis. As a non-invasive and immediate assessment, the Sonographic Murphy’s sign is invaluable in emergency medicine and general abdominal imaging.

Clinical Author

Bruno Vargas is originally from Mexico City. He first trained as an Emergency Medical Technician at la Universidad Panamericana (UP) before starting medical school at la Universidad Nacional Autónoma de México (UNAM) in Mexico City. Later he did his social service year in the Sierra Madre of Chiapas with Partners in Health Mexico/Compañeros en Salud (CES) in 2019, where he was trained in Global Health, social medicine, and introduced to Point of Care Ultrasound (POCUS). At that moment while working in a resource-limited setting he became passionate about POCUS. He graduated as a general practitioner, and afterward stayed with CES during the pandemic as part of the COVID-19 task force, training community healthcare workers and “pasantes” (first-year doctors doing their year of social service). He finished the Ultrasound Leadership Academy (ULA) fellowship and has started a POCUS training program at his site with midwives, nurses, doctors, and trainees from these areas. He is currently doing a Global Health Fellowship with HEAL as a site fellow in Chiapas with CES. He has committed to a lifelong career in global health providing healthcare access to the most marginalized communities. He has a profound respect and admiration for nature and loves any kind of outdoor activities, especially bicycling, high mountain, and scuba-diving.

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