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Related Experiment Videos

Imaging the patient with right upper quadrant pain.

M Nino-Murcia1, R B Jeffrey

  • 1Department of Radiology, VA Palo Alto Health Care System, Palo Alto, CA, USA.

Seminars in Roentgenology
|May 2, 2001
PubMed
Summary

Choosing the right imaging for right upper quadrant (RUQ) pain depends on clinical signs. Murphy sign positivity suggests sonography or biliary scintigraphy, while fever guides towards sonography and CT, or CT/MR for other cases.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Diagnostic Techniques

Background:

  • Right upper quadrant (RUQ) pain is a common clinical presentation.
  • Accurate diagnosis relies on selecting appropriate high-resolution imaging modalities.
  • Clinical signs and symptoms are crucial for guiding imaging choices.

Purpose of the Study:

  • To outline an evidence-based imaging approach for RUQ pain.
  • To correlate clinical findings with optimal diagnostic imaging techniques.
  • To improve diagnostic accuracy and efficiency in RUQ pain evaluation.

Main Methods:

  • Review of current high-resolution imaging techniques for RUQ pain.
  • Correlation of clinical signs (Murphy sign, fever) with imaging modality selection.

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  • Categorization of diagnostic pathways based on patient presentation.

    • Main Results:

    • Positive Murphy sign: Sonography and biliary scintigraphy are primary tools.
    • Fever with negative Murphy sign: Sonography and contrast-enhanced CT are effective.
    • No fever or negative Murphy sign: CT and Magnetic Resonance (MR) imaging are suitable first-line options.

    Conclusions:

    • A clinical sign-guided imaging strategy optimizes RUQ pain diagnosis.
    • Specific imaging modalities are recommended based on the presence of Murphy sign and fever.
    • This approach aids in efficient and accurate patient evaluation.