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Markle's sign, or jar tenderness, is a clinical sign in which pain in the right lower quadrant of the abdomen is elicited by the heel-drop test (dropping to the heels, from standing on the toes, with a jarring landing).
The scoring system was developed in 2008. [1] The AIR score was developed to overcome some of the drawbacks of the Alvarado score, another diagnostic scoring system for identifying appendicitis. [2]
In cases where the diagnosis is unclear, close observation, medical imaging, and laboratory tests can be helpful. [4] The two most commonly used imaging tests for diagnosing appendicitis are ultrasound and computed tomography (CT scan). [4] CT scan is more accurate than ultrasound in detecting acute appendicitis. [15]
The sign indicates aggravation of the parietal peritoneum by stretching or moving. Positive Blumberg's sign is indicative of peritonitis, [3] which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant.
Aaron's sign is a referred pain felt in the epigastrium upon continuous firm pressure over McBurney's point. [1] It is a non-specific sign of appendicitis. While the sign is well known, and taught in medical education, its efficacy has not been well established.
The hamburger sign is used in the diagnosis of appendicitis. [1] The sign is used to rule out that disease, with the physician inquiring if the patient would like to consume their favourite food. [2]
Murphy's triad was named after John Benjamin Murphy, an American physician and abdominal surgeons and one of the earliest advocates for the intervention of the removal of the appendix in all cases of appendicitis.
The combination of inflammation, reduced blood flow to the appendix, and distention of the appendix causes tissue injury, and tissue death. [6] If this process is left untreated, the appendix may burst, releasing bacteria into the abdominal cavity, leading to increased complications.