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Sunday, April 15, 2007

how to measure palpable spleen length or spleenomegaly?



Measuring length of spleen has been confusing medical students since years, many examiners giving subjective opinions and guidelines that may not serve purpose all the time. the misunderstanding which is taught most often is that spleen is to be measured as a perpendicular length from tip to costal margin or at midclavicular line. but that is wrong.

The correct way to measure palpable spleen length is the length from the tip of the spleen along the long axis, at the midpoint of green line C, the line that joins the points c1 and c2, that are the points where spleen gets retrocostal. Refer the image on right side, there are 3 spleens A B C. The yellow lines drawn give correct measurements of respective spleens even though the lines are not perpendicular to costal margin nor they are ending in midclavicular line.

Spleen length may be falsely small at times if perpendicular length or length upto midclavicular line on costal margin is taken, Just because the apex of spleen doesnt always lie along the line towards umbilicus and umbilicus doesnt always lie in center.