Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.
Classically, Murphy's sign is tested for during an abdominal examination in supine position; it is performed by asking the patient to breathe out and then gently placing the hand below the costal margin on the right side at the mid-clavicular line (the approximate location of the gallbladder).
Normally, during inspiration, the abdominal contents are pushed downward as the diaphragm moves down (and lungs expand).
In order for the test to be considered negative, the same maneuver must not elicit pain when performed on the left side.
[3] The sign is named after American physician John Benjamin Murphy (1857–1916), a Chicago surgeon from the 1880s to the early 1900s, who first described the hypersensitivity to deep palpation in the subcostal area when a patient with gallbladder disease takes a deep breath.