Sherpelman sign

Schepelmann's sign is a method of distinguishing pleurisy from intercostal neuralgia. Ask the patient to stand upright and ask him to flex his trunk to the left and right, and watch his painful response. In pleurisy, the pain worsens when the trunk is flexed to the healthy side, and the pain disappears when flexed to the affected side; the opposite is true for intercostal neuralgia. The former is caused by the pleural pleura being stretched, and the latter is the result of compression of the intercostal nerve.