- The Markle Sign, Markle Test or Heel Drop Jarring Test is elicited in patients with intraperitoneal inflammation by having a patient stand on his or her toes and suddenly dropping down onto the heels with an audible thump.
- If abdominal pain is localised as the heels strike the ground, Markle’s Sign is positive. If the pain is localised to the right lower quadrant, this is suggestive of acute appendicitis.
- In a series of 190 appendectomies, 74% of the patients with acute appendicitis had a positive Markle Sign.
- The Markle Sign was shown to be superior to the better known ‘rebound test’ and at least as accurate as the white blood cell count as a diagnostic marker in acute appendicitis. Markle GH. American Journal of Surgery. 1973 [Abstract]
Review Letter to the Editor – 1985
George Bushar Markle IV Biography
George Bushar Markle IV (1921 – 1999) was an American surgeon. Eponymously linked to the Markle Sign.
- Born 19 October 1921 in Pennsylvania, United States
- 1943 – Bachelor of Science, Yale University
- 1946 – Doctor of Medicine, University Pennsylvania
- 1949-1952 Surgical fellow, Mayo Clinic, Rochester, Minnesota
- 1952-1954 Chief of surgery, United States Army Hospital, Fort Monroe, Virginia
- 1954-1994 Carlsbad Regional Medical Center, New Mexico
- Died 1 October 1999, Carlsbad, New Mexico
- 1966 – Markle IV, GB. Ill Health and Other Foolishness
- 1982 – Markle IV, GB. The Teka Stone
- 1991 – Markle IV, GB. How to Be Healthy Wealthy and Wise and Have Time to Enjoy It
- 1998 – Markle IV, GB. Beyond Ophir
- Markle, GB. A simple test for intraperitoneal inflammation. The American Journal of Surgery. 1973; 125(6): 721-722 [Abstract]
- Markle GB. Heel-Drop Jarring Test for Appendicitis. Arch Surg. 1985;120(2):243. [JAMA]
- Eponymythology: Appendicitis eponymous signs. LITFL