title: Should we estimate liver span in the right mid-clavicular line or the midline?
abstract: OBJECTIVE
  Comparison was made between the accuracy of repeated measurements of liver projection below the costal margin in the right mid-clavicular line (RMCL) and in the midline (ML).
  
  
  METHODS
  Clinical measurement of liver span was studied in 34 children under 5 years of age by five members of junior ward staff. Three patients were followed longitudinally by the same observers.
  
  
  RESULTS
  The coefficient of reliability between different observers for measurement in the RMCL was 13 mm but for that in the ML was 7 mm. Estimates of liver size in the RMCL were particularly inaccurate when examining larger livers.
  
  
  CONCLUSIONS
  More reliable sequential estimates of liver size are likely to be obtained using measurements both in the midline and in a well-defined and agreed point below the right costal margin.
authors.affiliation: Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, London, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Michie
authors.forename: S
authors.initials: S
authors.lastname: Alu
authors.forename: K
authors.initials: K
authors.lastname: Wild
authors.forename: R
authors.initials: R
authors.lastname: Hampsheir
authors.forename: P
authors.initials: P
authors.lastname: Chabonnaud
authors.forename: D
authors.initials: D
authors.lastname: Harvey
mesh_terms: D000367:Age Factors; D000886:Anthropometry / Q000379:methods*; D002675:Child, Preschool; D006529:Hepatomegaly / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D015588:Observer Variation; D010173:Palpation / Q000379:methods*; D010474:Percussion / Q000379:methods; D015203:Reproducibility of Results