What clinical sign is indicative of acute cholecystitis during physical examination?

Murphy's sign is a key clinical indicator of acute cholecystitis during physical examination. It is performed by palpating the right upper quadrant of the abdomen while asking the patient to take a deep breath. A positive Murphy's sign occurs when the patient experiences pain or interruption of breathing due to tenderness upon palpation of the gallbladder. This symptom arises from inflammation and irritation of the gallbladder wall, commonly seen in cases of acute cholecystitis. The presence of this sign greatly aids in the diagnosis of the condition, along with other clinical findings and imaging studies.

Other clinical signs such as rebound tenderness and abdominal rigidity can be indicative of various abdominal conditions, including peritonitis, but are not specific to cholecystitis. Rosving's sign, which involves palpation of the left lower quadrant leading to pain in the right lower quadrant, is more suggestive of appendicitis. Thus, Murphy's sign remains the definitive physical examination finding that directly correlates with acute cholecystitis.