Diagnostic Accuracy of different Methods of Palpation and Percussion of Spleen for Detection of Splenomegaly in Children

Background: Standard medical physical examination plays a major role in the decision-making regarding the diagnosis, investigations, and treatment of any illness or the teaching and examination of doctors-in-training. Unfortunately, standard medical examination still has yet to be thoroughly studied upon. The skill and ability to percuss and palpate the spleen to successfully detect and analyze the splenomegaly is a difficult task in infants and adolescents. Objective: Here in this study we would like to know the accuracy and reliability of clinical examination (by using three different methods of percussion and palpation) for detecting splenomegaly in children. Methodology: In this cross-sectional study, the eligible children will be examined by the three paediatric residents for splenomegaly by different methods. For palpation, supine palpation maneuver, Middleton’s hooking maneuver, and right lateral decubitus methods will be used whereas for percussion, traube's space percussion, castell's maneuver and Nixon’s maneuver will be used. Each patient will be subject to three methods of percussion and palpation each. After that, we will do the ultrasonography of the patient for detection of the splenomegaly. Results: After the completion of the study, we will come to know the accuracy and reliability of the clinical examination (palpation and percussion) of the spleen for the detection of splenomegaly. Conclusion: We will come to know the diagnostic accuracy of the different methods of palpation and percussion for detecting splenomegaly.