Physical examination maneuver

Physical Exam

Ear Inspection and Palpation

also known as Ear inspection
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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

Showing 5 of 13 findings

Acute Otitis Media

Bulging tympanic membrane in a child
Rule in
Very helpful
Rule out
—
Evidence:Moderate
Distinctly immobile tympanic membrane on pneumatic otoscopy in a child
Rule in
Very helpful
Rule out
—
Evidence:Moderate
Cloudy (opaque) tympanic membrane in a child
Rule in
Very helpful
Rule out
Helpful
Evidence:Moderate

Coronary Artery Disease

Diagonal earlobe crease
Rule in
Minimally helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Mortality

Diagonal earlobe crease (grade 2/3) in a patient with acute myocardial infarction
Rule in
Not helpfulDerived CI
Rule out
Somewhat helpfulWide CI
Evidence:Moderate

Related Bedside Tests

OtoscopyMembers
Sign in
Otoscopy
Rule in:VHAcute Otitis Media, SHOtitis Media with Effusion, IEBasilar Skull Fracture +5 more
Rule out:VHOtitis Media with Effusion, IEAcute Otitis Media, IEBasilar Skull Fracture +5 more
🎬Video coming soon
Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
Heart RateMembers
Sign in
Heart Rate
Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
🎬Video coming soon
Capillary Refill
aka Capillary refill time | CRT | Nail blanch test
Rule in:VHMortality, VHPostoperative Complication, HHypovolemia +8 more
Rule out:HMortality, SHPostoperative Complication, MHDehydration +8 more
Cardiac AuscultationMembers
Sign in
Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy +37 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHRight-sided Valvular Lesion +37 more
🎬Video coming soon
Spleen Palpation
Rule in:VHSplenomegaly, HMalaria, SHCirrhosis +13 more
Rule out:SHMyelofibrosis, MHInfectious Mononucleosis, MHSplenomegaly +13 more

Related Systems / Regions

CardiovascularHead, Eyes, Ears, Nose, Throat

Related Diagnoses

Acute MastoiditisAcute Otitis MediaBasilar Skull FractureCholesteatomaCoronary Artery DiseaseGoutMortalityOtitis ExternaOtitis Media with Effusion

Related Chief Complaints

Bruising Behind the EarChest PainChronic Ear DrainageDizzinessEar Canal SwellingEar DischargeEar DrainageEar FullnessEar ItchingEar PainEar Pain in a ChildEar PoppingEar PullingEar Pushed ForwardFeverFoul-smelling Ear DischargeHead InjuryHeadacheHearing LossIrritabilityIrritability in a ChildJoint PainLump on the EarMuffled HearingPain with Touching the EarPoor FeedingProtruding EarRecurrent Ear InfectionsRedness Behind the EarRinging in the EarSwelling Behind the EarTrouble SleepingWhite Mass Behind the Eardrum

References

Research in progress on one or more findings above; ratings may change.

  • 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 XL, Yang DY, Zhao YS, Chai WH, Jin ML. 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.