Physical examination maneuver
Physical Exam
Temperature
🎬
Video coming September 2026
How to Perform
Measure body temperature with a thermometer at a standard site — oral (in the sublingual pocket with the mouth closed), tympanic, temporal, axillary, or rectal — following the device's instructions, and record the site used along with the reading. Avoid taking an oral temperature soon after hot or cold drinks.
How to Interpret
Showing 2 of 6 findings
Appendicitis
Fever (temperature greater than or equal to 38 C) in a child
Rule in
—
Rule out
Minimally helpful
Evidence:Strong
Pneumonia
Fever (temperature ≥38°C / 100.4°F)
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Strong
References
- Htun TP, Sun Y, Chua HL, Pang J. Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review. Sci Rep. 2019;9(1):7600. doi:10.1038/s41598-019-44145-y. PMID: 31110214. PMC: PMC6527561. Open access. PRISMA-compliant systematic review with QUADAS-2 quality assessment. 13 included studies (n=11,144 total adult participants in primary care, outpatient, and emergency department settings). 9 included studies assessed elevated temperature as an index test; pooled at the ≥38°C threshold per Htun's Table 2 random-effects bivariate model. Reference standard for pneumonia: chest radiograph in 13 studies.
- Primary teaching reference: Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. Chest. 1992;101(6):1644-55. doi:10.1378/chest.101.6.1644. PMID: 1303622. Modern guideline framing: Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287. PMID: 26903338. PMC: PMC4968574. Sepsis-3 qSOFA derivation/validation: Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis. JAMA. 2016;315(8):762-774. doi:10.1001/jama.2016.0288. PMID: 26903335.
- Primary SIRS-criterion reference: Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest. 1992;101(6):1644-55. PMID: 1303622. Sepsis-3 framing: Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. PMID: 26903338. Hypothermic-sepsis prognostic literature (modern open-access reviews and cohort studies): Drewry AM, Fuller BM, Bailey TC, Hotchkiss RS. Body temperature patterns as a predictor of hospital-acquired sepsis in afebrile adult intensive care unit patients: a case-control study. Crit Care. 2013;17(5):R200. doi:10.1186/cc12894. PMID: 24028682. PMC: PMC3906745. Wiewel MA, Harmon MB, van Vught LA, et al. Risk factors, host response and outcome of hypothermic sepsis. Crit Care. 2016;20:328. doi:10.1186/s13054-016-1510-3. PMID: 27737683. PMC: PMC5064842. Tiruvoipati R, Ong K, Gangopadhyay H, et al. Hypothermia predicts mortality in critically ill elderly patients with sepsis. BMC Geriatr. 2010;10:70. PMID: 20875107. PMC: PMC2955035.
- Modified Duke criteria primary reference: Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):633-8. doi:10.1086/313753. PMID: 10770721. Most recent update: Fowler VG, Durack DT, Selton-Suty C, et al. The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: Updating the Modified Duke Criteria. Clin Infect Dis. 2023;77(4):518-526. doi:10.1093/cid/ciad271. PMID: 37138445. Modern AHA guideline reference: Baddour LM, Wilson WR, Bayer AS, et al. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation. 2015;132(15):1435-86. doi:10.1161/CIR.0000000000000296. PMID: 26373316. Modern epidemiology / prevalence reference: Cahill TJ, Prendergast BD. Infective endocarditis. Lancet. 2016;387(10021):882-93. doi:10.1016/S0140-6736(15)00067-7. PMID: 26341945.
- Primary BWPS reference: Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22(2):263-77. PMID: 8325286. Modern guideline reference: Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016;26(10):1343-1421. doi:10.1089/thy.2016.0229. PMID: 27521067. (Open access; addresses thyroid storm as Section 11.) Validation/comparison reference: Akamizu T, Satoh T, Isozaki O, et al. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid. 2012;22(7):661-79. doi:10.1089/thy.2011.0334. PMID: 22690898. PMC: PMC3387770. (Japan Thyroid Association criteria, validated alternative to BWPS.)
- Bundy DG, et al. Does this child have appendicitis? JAMA. 2007;298(4):438-451. PMID: 17652298.
- 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.
Related Diagnoses
Related Chief Complaints
Abdominal PainAbdominal Pain in a ChildAbdominal TendernessAgitationAnxietyBack PainChest PainChillsCold ExtremitiesConfusionCoughCough Productive of SputumDiarrheaEasy BruisingFatigueFeverHeart MurmurHeat IntoleranceIrritabilityLightheadednessLoss of AppetiteLow Blood PressureNauseaNausea and VomitingNeck SwellingNight SweatsPalpitationsPleuritic Chest PainRapid BreathingRecurrent InfectionsRefusal to EatRight Lower Quadrant PainShortness of BreathStroke SymptomsSweatingSwollen Lymph NodesTremorVomitingWeaknessWeight Loss
Related Systems / Regions
Related Bedside Tests
🎬Video coming Sept 2026
Heart Rate
Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more
Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more
🎬Video coming Sept 2026
Respiratory Rate
Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more
Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more
🎬Video coming Sept 2026
Lung Auscultation
Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more
Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more
🎬Video coming Sept 2026
Oxygen Saturation
aka Pulse oximetry
Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more
Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more
🎬Video coming Sept 2026
Psoas Sign
aka Iliopsoas sign; Obraztsov's sign
Rule in:SHAppendicitis (Adult), SHAppendicitis (Pediatric)
🎬Video coming Sept 2026
Capillary Refill
Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more
Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more
