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Homan's sign

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Homan's sign is an indicator of deep venous thrombosis. The sign is present where pain in the calf is produced by passive dorsiflexion of the foot.

However it has been noted that clinical symptoms and signs are of little help in the diagnosis of venous thrombosis of the legs because they lack both sensitivity and sensitivity (1,2):

  • Homan's sign, swelling and erythema have sensitivities of 60-88% and specificities of 30-72% in well-designed studies for the diagnosis of deep vein thrombosis (using venography as the reference standard) (2)
  • studies of Homan's sign suggest it is positive from 8 to 56% of people with proven deep venous thrombosis (DVT), but also positive in more than 50% of symptomatic people without DVT (2)

Homan's sign may be positive in both DVT of the calf and ruptured Baker's cyst (3).

The test has fallen into disfavour because of the lack of sensitivity and specificity for a diagnosis of deep vein thrombosis.

Reference:

  1. Mannucci PM, Poller L. Venous thrombosis and anticoagulant therapy. Journal of Haematology 2001;114(2): 258-270.
  2. Joshua AM et al. Beauty is in the eye of the examiner: reaching agreement about physical signs and their value. Internal Medicine Journal 2005; 35(3):178-187.
  3. Postgraduate Medical Journal 2002;78:304.

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