Castell’s Percussion Test

Technique

Splenic Percussion Sign (Castell’s Sign): Percuss the most inferior interspace on the left anterior axillary line (Castell’s Point).

This is usually tympanic. Ask patient to breath deeply.

•    Remains tympanic on inspiration: Splenic Percussion Sign negative: splenomegaly less likely.
•    Shift from tympanic to dullness: Splenic Percussion Sign positive: splenomegaly more likely.