Heel tap sign

Heel tap sign, also called heel-jar or jar tenderness, is a clinical sign to identify appendicitis. It is found in patients with localized peritonitis. The right heel is elevated by 10-20 degrees and the heel is hit firmly with palm of the examiner's hand.^[1]

The prehospital equivalent of this sign is when pain is elicited as the ambulance hits bumps and potholes during the transport of the patient. Pain may be severe and may radiate to other areas with movement.

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.

References

↑ Lawrence, Peter F.; Bell, Richard M.; Dayton, Merril T. (31 October 2012). Essentials of General Surgery. Lippincott Williams & Wilkins. p. 295. ISBN 978-0-7817-8495-5.

Symptoms and signs: digestive system and abdomen (R10–R19, 787,789)

Upper	Nausea Vomiting Heartburn Aerophagia Dysphagia oropharyngeal esophageal Odynophagia Halitosis Xerostomia Hypersalivation Burping Wet burp

Defaecation	Flatulence Fecal incontinence Encopresis Blood: Fecal occult blood Rectal tenesmus Constipation Obstructed defecation Diarrhea Rectal discharge Football sign Psoas sign Obturator sign Rovsing's sign Hamburger sign Heel tap sign Aure-Rozanova's sign Dunphy sign Alder's sign Lockwood's sign Rosenstein's sign

Abdomen	Abdominal pain Acute abdomen Colic Baby colic Abdominal guarding Rebound tenderness Abdominal distension Bloating Ascites Tympanites Shifting dullness Bulging flanks Fluid wave test Abdominal mass Hepatosplenomegaly Hepatomegaly Splenomegaly Jaundice Mallet-Guy sign Puddle sign

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