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Should we estimate liver span in the right mid-clavicular line or the midline?
1Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, London, United Kingdom.
Objective:
Comparison was made between the accuracy of repeated measurements of liver projection below the costal margin in the right mid-clavicular line (RMCL) and in the midline (ML).
Methodology:
Clinical measurement of liver span was studied in 34 children under 5 years of age by five members of junior ward staff. Three patients were followed longitudinally by the same observers.
Results:
The coefficient of reliability between different observers for measurement in the RMCL was 13 mm but for that in the ML was 7 mm. Estimates of liver size in the RMCL were particularly inaccurate when examining larger livers.
Conclusion:
More reliable sequential estimates of liver size are likely to be obtained using measurements both in the midline and in a well-defined and agreed point below the right costal margin.