Clinical Signs in Surgery: Are They Still Relevant?

Teaching surgery is a great opportunity to learn and rediscover your own self through the eyes of your students, the taught thus becomes teacher’s ultimate evaluator. Skilled clinical examination remains an important part of the management of any disease. While teaching and examining students across the country, one has observed that some traditional clinical tests of the beaten path that have long lost their relevance and utility continue to be part of the examination drill. A large number of these have a very poor sensitivity and specificity and are often cruel to the patients. We however continue to persist with them regardless. Whether there is something wrong with the tests or the teachers (or the taught) would need to be addressed. Like most clinical tests, the sensitivity of clinical signs is also expected to drop with time especially when more sensitive tools are universally available. It would therefore bemandatory to revisit these clinical tests in the light of present day and age, although it may amount to stumbling on the shoulders of giants. To explain this point further, following are some amongst the many clinical signs that the author felt should be revisited.