Markle sign

The Markle sign or jar tenderness is a clinical sign in which pain in the right lower quadrant of the abdomen is elicited by dropping from standing on the toes to the heels with a jarring landing. It is found in patients with localised peritonitis due to acute appendicitis.[1] It is similar to rebound tenderness, but may be easier to elicit when the patient has firm abdominal wall muscles. Abdominal pain on walking or running is an equivalent sign.[2]

It was first described by the George Bushar Markle IV (19211999), an American surgeon, in 1985.[3]


  1. Acute appendicitis on Medscape
  2. Richard F. LeBlond, Richard L. DeGowin, Elmer Louis DeGowin, Jim Abel. DeGowin's Diagnostic Examination, page 481. McGraw Hill Professional, 2008. ISBN 978-0-07-147898-4. Google books
  3. Markle, George B. "A simple test for intraperitoneal inflammation". The American Journal of Surgery. 125 (6): 721–722. doi:10.1016/0002-9610(73)90171-2.
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