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Various studies suggest that physical examination can detect splenomegaly in 28 percent to 82 percent of cases, but few studies have validated their findings with imaging studies. This prospective, double-blind study compared six physical diagnostic methods with splenic ultrasonography.
Eight examiners were taught three palpation methods (bimanual palpation, ballottement, and palpation from above) and three percussion techniques. Each examined 27 HIV- infected patients using all six methods, in random order, and recorded their findings for each method. One third of the patients had splenomegaly documented by ultrasound.
Physical examination had a sensitivity of 0 percent to 64 percent for palpation and 8 percent to 75 percent for percussion, …