Heel-Drop Jarring Test for Appendicitis
Archives of Surgery
(Impact Factor: 4.93).
03/1985; 120(2):243. DOI: 10.1001/archsurg.1985.01390260101015
To the Editor.—The heel-drop jarring test for appendicitis and other intraperitoneal inflammation, also known as the Markle test, was published in 1973 and, as a simple bedside test, was shown to be superior to the better-known rebound test.1 A recent review of a series of 190 appendectomies confirmed this advantage and in addition, the test was found to be at least as accurate as the white blood cell (WBC) count and differential cell count.In a series of 190 appendectomies the appendix was normal in 30 patients (15.8%). Seventy-four percent of the patients with acute appendicitis had a positive heel-drop test, with helpful localization in 71% compared with 64% and 37% for the rebound test, respectively. The WBC count was at least 10,000/cu mm in 69% of the patients and the differential cell count was 68 or more (totals of neutrophils plus immature forms) in 71% of the
Available from: ncbi.nlm.nih.gov
- "The use of indirect tests such as the “cough test,” where one looks for signs of pain such as flinching, grimacing, or moving the hands to the abdomen upon coughing has a similar sensitivity but with a specificity of 79%.35 In children, indirect tests would include the “heel drop jarring” test (child rises on toes and drops weight on heels) or asking the child to jump up and down while looking for signs of abdominal pain.29,36 "
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ABSTRACT: Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.
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