Physical Exam

Ear Inspection and Palpation

also known as Ear inspection

🎬

Video coming September 2026

How to Perform

Inspect the auricle and surrounding tissues for size, shape, position, and symmetry, and for any deformity, swelling, redness, lesions, or discharge. Note the condition of the skin and of the external auditory meatus, and inspect behind the ear over the mastoid. Move the auricle and press on the tragus, noting any tenderness.

How to Interpret

Acute Otitis Media

Bulging tympanic membrane in a child

Rule in

Very helpful

Rule out

—

Evidence:Limited

Distinctly immobile tympanic membrane on pneumatic otoscopy in a child

Rule in

Very helpful

Rule out

—

Evidence:Limited

Cloudy (opaque) tympanic membrane in a child

Rule in

Very helpful

Rule out

Helpful

Evidence:Limited

Coronary Artery Disease

Diagonal earlobe crease

Rule in

Minimally helpfulDerived CI

Rule out

Somewhat helpfulDerived CI

Evidence:Limited

References

Rothman R, Owens T, Simel DL. Does this child have acute otitis media? JAMA. 2003;290(12):1633-1640. PMID 14506123.
Rothman R, Owens T, Simel DL. Does this child have acute otitis media? JAMA. 2003;290(12):1633-1640. PMID: 14506123.
Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical practice guideline: acute otitis externa executive summary. Otolaryngol Head Neck Surg. 2014;150(2):161-168. PMID: 24492208.
Thilo C, Meisinger C, Heier M, von Scheidt W, Kirchberger I. Diagonal earlobe crease and long-term survival after myocardial infarction. BMC Cardiovasc Disord. 2021;21(1):597. PMID: 34915852.
Wu X, Yang D, Zhao Y, Chai W, Jin M. Diagonal earlobe crease and coronary artery disease in a Chinese population. BMC Cardiovasc Disord. 2014;14:43. PMID: 24708687.
Takata GS, Chan LS, Morphew T, Mangione-Smith R, Morton SC, Shekelle P. Evidence assessment of the accuracy of methods of diagnosing middle ear effusion in children with otitis media with effusion. Pediatrics. 2003;112(6):1379-1387. PMID: 14654613.
Neogi T, Jansen TLTA, Dalbeth N, et al. 2015 Gout Classification Criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheumatol. 2015;67(10):2557-2568. PMID: 26352873.
Pretto Flores L, De Almeida CS, Casulari LA. Positive predictive values of selected clinical signs associated with skull base fractures. J Neurosurg Sci. 2000;44(2):77-82. PMID: 11105835.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.