A study of the reliability of clinical palpation of the spleen.

Clinical palpation of the spleen was assessed by reference to a radionuclide scan method for measuring spleen volume in vivo from V = 9.88A - 534, where V = volume (cm3) and A = posterior scan area (cm2) (Zhang & Lewis 1987). The position of the spleen tip in relation to the costal margin correlated well with clinical palpability when the spleen was clearly enlarged, but when the spleen tip was just below the costal margin it was not always palpable. In some cases a normal-sized spleen was palpable, whereas a non-palpable spleen was not always normal sized. As the scanning method gives an accurate measurement of spleen size it is especially useful in lesser degrees of enlargement when reliable information on the splenomegaly may help to elucidate a diagnosis and problems of management.