The gallbladder of a 51-year-old female patient is characterized by the presence of multiple gallstones, consistent with the diagnosis of cholecystitis. Which of the following tests would be anticipated to be positive in this patient?
Murphy's sign is a specific test designed to detect and diagnose problems in the upper right abdominal quadrant. It is classically used to diagnose problems of the gallbladder by pressing deeply under the right costal margin and asking the patient to breathe deeply. This causes sharp pain in the patient with cholecystitis. Rebound tenderness is pain experienced when applied pressure is removed quickly from a location on the body. It is not specific to areas of the body and is not indicative of problems in the upper right quadrant. The iliopsoas test is generally used to diagnose appendicitis because flexing the iliopsoas muscle group applies pressure to the ascending colon and appendix. When the appendix is inflamed, this pressure elicits pain. The obturator sign is used to diagnose irritation of the obturator internus muscle and would not elicit a positive test with the patient's current symptoms. Finally, cough tenderness would not be present because it is generally associated with hernias and problems associated with rises in intraabdominal pressure.
Rebound tenderness
Iliopsoas test
Obturator sign
Murphy's sign
Abdomen & Pelvis