Clinical Signs – The Forgotten Art! A Review for Postgraduate Medical Students

Clinical medicine has undergone a paradigm shift over the past few decades, with diagnostic imaging and laboratory investigations increasingly dominating clinical decision-making. While these advances have undoubtedly improved diagnostic precision, they have also contributed to a gradual erosion of bedside examination skills. Many classical clinical signs — once central to diagnosis — are now rarely sought or taught in routine practice. This review revisits the relevance of physical signs in modern medicine, explores why they have been neglected, and highlights nine important but underutilised clinical signs across multiple systems. Each sign is discussed with respect to its historical origins, method of elicitation, pathophysiological basis, and current clinical relevance. Two newly described signs—the ‘Pruritic polished nail sign’ and the ‘Hepatic scratch transmission sign’ — are also introduced as original contributions to contemporary clinical semiology.