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Review
of Clinical Signs

Homans’ Sign

Series Editor and Author: Frank L. Urbano, MD

1. Which of the following conditions will not cause a positive Homans’ sign?
  1. Calf muscle sprain
  2. Deep venous thrombosis
  3. Herniated intervertebral disc
  4. Patellar tendonitis
  5. Ruptured Baker’s cyst
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2. Which of the following statements is accurate regarding Homans’ sign?

  1. Because it is easy to elicit and interpret, Homans’ sign is very cost-effective in the diagnosis of deep venous thrombosis
  2. Homans’ sign is generally considered to be both sensitive and specific in the diagnosis of deep venous thrombosis
  3. The knee should be extended to elicit Homans’ sign
  4. The patient should dorsiflex the foot without any help from the examiner, and the examiner should observe the patient for pain in the calf, which indicates a positive sign
  5. Performing the maneuvers to elicit Homans’ sign may exert traction on the posterior tibial vein, thus causing the pain associated with the sign
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  3. Which of the following statements is accurate regarding the diagnosis of deep venous thrombosis?
  1. Clinical criteria have no role in the diagnosis of deep venous thrombosis, because they are generally unreliable
  2. Homans’ sign is more than 60% accurate in diagnosing the presence of calf vein thrombi
  3. Impedance plethysmography is useful for detecting all types of leg vein thrombi, particularly calf vein thrombi
  4. Ultrasonography is less accurate than impedance plethysmography in the diagnosis of deep venous thrombosis
  5. Venography is highly accurate but is invasive and not without complications
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Updated 1/04/08 • kkj