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Richard R. Babb, MD
Palo Alto Medical Clinic Palo Alto, Calif

JAMA. 1997;277(8):625-626.

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

To the Editor.

—In their review of the bedside approach to a patient with suspected acute appendicitis, Dr Wagner and colleagues¹ note the usefulness of several helpful physical examination findings, including guarding, rigidity, and rebound tenderness. I would like to describe another rarely used and seldom appreciated sign that is helpful in the diagnosis of infection or inflammation in the right lower guadrant.

In 1973, Markle² published his experience with the "heel-drop jarring test" in 54 patients with suspected acute appendicitis and reported that this sign was more sensitive than rebound tenderness. In the heel-drop jarring test, the patient stands, goes up on his or her toes for 15 seconds, and then comes down with full weight on his or her heels. . . . [Full Text PDF of this Article]

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