Should we estimate liver span in the right mid‐clavicular line or the midline?

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). Methodology: 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. Conclusion: 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.