I bought a Bisley Flattop in .44 SPL last year but just could not get used to the grips. Sold it last weekend and picked up a Blackhawk Flattop in .44 SPL to replace it. Same grip as my brace of .44 SPL Vaqueros that I use for Cowboy.
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All .44Spec revolvers from Ruger are on the medium frame (BH or New Vaquero). The BH is a cataloged item by Ruger ... Not just a Lipsey special run :) Wahoo.
Bring your calipers ;) . Just kidding. See the flattop on the BH above? That is almost a dead giveaway. If it has 'ears' around the rear sight it is a large frame (excluding OM .357s and small frame .22s) . The serial number will be three digits instead of two . xxx-yyyyy instead of xx-yyyyy. Hope that helps! Again, the ONLY cataloged BH that is on the medium frame is the .44Spec. Lipseys has special runs of .45 Colt/.45 ACP on the medium frame as well and of course the 50th anniversary .357 flattop.
And on the New Vaquero. Think of the New Vaquero as just a flattop BH with Fixed Sights.... The author has measurements and pictures of the difference is sizes between the large frame and medium frame.