This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Steven A. Grover, MD; Alan N. Barkun, MD
McGill University Montreal, Quebec

David L. Sackett, MD
McMaster University Hamilton, Ontario

JAMA. 1994;272(7):516.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—Dr Rosenman may be quite correct that an expert in the magical art of percussion requires a soft touch, a sharp ear, and a tongue in cheek. However, we believe that our review of the bedside assessment of splenomegaly dealt not with the art of percussion, but with the science for which a tongue in cheek can only introduce background noise that obscures the truth.

In reviewing clinical studies objectively evaluating the precision and accuracy of percussion and palpation, we hoped to provide a rational set of guidelines that identified the clinical situations where these bedside maneuvers might be useful to diagnose splenic enlargement. Just as important, we also identified clinical scenarios in which these maneuvers are probably of little clinical value, such as ruling out splenomegaly.

Accordingly, we agree with Rosenman that the art of percussion is best practiced by drum players. However, we believe there remains . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?