Chapman points
Notes
Chapman points
Chapman points
Chapman points are palpable, discrete areas, located in predictable locations, that are manifestations of visceral somatic dysfunction. They represent lymphatic congestion in the underlying fascia at that area. These points manifest as small, 2–3 mm diameter nodules that are often painful (without radiation), edematous, and boggy. Since they are consistently found in the same locations, they can aid in the diagnosis of medical illness and help narrow down a differential diagnosis. Many of the anterior Chapman points are located in the intercostal spaces, while most posterior points are located on the transverse processes.
LOCATION OF CHAPMAN POINTS BY BODY REGION
| HEAD AND NECK | |||||||||
| REGION | ANTERIOR | POSTERIOR | DIAGNOSIS EXAMPLE | ||||||
| Ear | Supraclavicular, at crossing of 1st rib | C1 lateral pillar | Otitis media | ||||||
| Nasal sinus | Infraclavicular, at crossing of 1st rib | C1 articular pillar | Seasonal allergies | ||||||
| Sinus | Superior edge of 2nd rib | C2 articular pillar | Sinusitis | ||||||
| Tonsils | 1st intercostal space | N/A | Tonsillitis | ||||||
| Pharynx | Anterior 1st rib, one inch lateral to sternum | C2 articular pillar | Pharyngitis | ||||||
| Larynx | Upper surface of 2nd rib | C2 articular pillar | Laryngitis | ||||||
| Eye (retina, conjunctiva) | Lateral aspect of humerus | Posterior to mastoid process | Conjunctivitis | ||||||
| Neck | Medial aspect of surgical humeral neck | C3–C7 articular pillars | Strain of the scalenes | ||||||
| CARDIOPULMONARY | |||||||||
| REGION | ANTERIOR | POSTERIOR | DIAGNOSIS EXAMPLE | ||||||
| Heart | 2nd intercostal space | T3 transverse process | Myocarditis | ||||||
| Bronchi | 2nd intercostal space | T2 transverse process | Bronchitis | ||||||
| Upper lung | 3rd intercostal space | T3 transverse process | Asthma | ||||||
| Lower lung | 4th intercostal space | T4 transverse process | Pneumonia | ||||||
| GASTROINTESTINAL | |||||||||
| REGION | ANTERIOR | POSTERIOR | DIAGNOSIS EXAMPLE | ||||||
| Esophagus | 2nd intercostal space | T2 transverse process | GERD | ||||||
| Pylorus | Midsternal | T9 transverse process (right) | GERD | ||||||
| Stomach (acidity) | 5th intercostal space (left) | T5 transverse process (left) | GERD | ||||||
| Stomach (peristalsis) | 6th intercostal space (left) | T6 transverse process (left) | Gastroparesis | ||||||
| Spleen | 7th intercostal space (left) | T7 transverse process (left) | Splenomegaly | ||||||
| Liver | 5th intercostal space (right) | T5 transverse process (right) | Hepatitis | ||||||
| Gallbladder | 6th intercostal space (right) | T6 transverse process (right) | Cholecystitis | ||||||
| Pancreas | 7th intercostal space (right) | T7 transverse process (right) | Pancreatitis | ||||||
| Small intestine | 8th–10th intercostal spaces | T8–T10 transverse processes | Celiac disease | ||||||
| Large intestine | Along iliotibial (IT) band | L2–L4 transverse processes | Diverticulitis | ||||||
| Appendix | Tip of 12th rib | T11 transverse process (right) | Appendicitis | ||||||
| Rectum | Lesser trochanter of femur | Sacroiliac (SI) joint | Hemorrhoids | ||||||
| URINARY | |||||||||
| REGION | ANTERIOR | POSTERIOR | DIAGNOSIS EXAMPLE | ||||||
| Kidney | 1 inch lateral and 1 inch superior to umbilicus | L1 transverse process | Pyelonephritis | ||||||
| Bladder | Periumbilical | L2 transverse process | Cystitis | ||||||
| Urethra | Superior pubic ramus | L3 transverse process | Urethritis | ||||||
| Prostate | Posterior IT band | PSIS | Prostatitis | ||||||
| ENDOCRINE | |||||||||
| REGION | ANTERIOR | POSTERIOR | DIAGNOSIS EXAMPLE | ||||||
| Thyroid | 2nd intercostal space | T2 transverse process | Thyroiditis | ||||||
| Adrenal gland | 1 inch lateral and 2 inches superior to umbilicus | T11 transverse process | Adrenal adenoma | ||||||
| REPRODUCTIVE | |||||||||
| REGION | ANTERIOR | POSTERIOR | DIAGNOSIS EXAMPLE | ||||||
| Ovary, testis | Superior pubic ramus | T10 transverse process | Ovarian torsion, orchitis | ||||||
| Uterus | Inferior pubic ramus | L5 transverse process, lateral sacral base | Endometritis | ||||||
| Fallopian tubes / seminal vesicles | Midway between acetabulum and sciatic notch | Lateral sacral base | Ectopic pregnancy | ||||||
| Vagina | Inner thigh | Lateral sacral base | Vaginitis | ||||||
| Broad ligament | Posterior IT band | Lateral sacral base | Broad ligament teratoma | ||||||
Figure 1. Anterior Chapman points. All points are bilateral unless otherwise noted with L (left), R (right), or MIDLINE.
Figure 2. Posterior Chapman points. All points are bilateral unless otherwise noted with L (left) or R (right).
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Illustrator: Jillian Dunbar
Editor: Robyn Hughes, MScBMC
Summary
Chapman points, also known as Chapman's reflex points, are discrete, palpable tissue areas resulting from a neuro lymphatic congestion caused by underlying visceral dysfunction. They are commonly located between the skin and subcutaneous tissue. In Osteopathic medicine, Chapman's points are used for both diagnostic and therapeutic reasons.