Hoover's sign

Hoover's sign

Hoover’s sign refers to one of two signs named for Charles Franklin Hoover.cite web |url=http://www.cwru.edu/artsci/dittrick/cemetery/stop13.htm |title=George Crile, Charles Hoover and John Phillips |format= |work= |accessdate=]

Charles Franklin Hoover (1865–1927)cite journal |author=Caplan LR |title=Charles Franklin Hoover (1865-1927) |journal=J. Neurol. |volume=251 |issue=1 |pages=118–9 |year=2004 |month=January |pmid=14999504 |doi=10.1007/s00415-004-0309-3 |url=http://dx.doi.org/10.1007/s00415-004-0309-3] was an American physician born in Cleveland, Ohio, who read medicine at Harvard. He worked in Vienna under Neusser, and in Strasburg with F Kraus before returning to Cleveland. He was appointed Professor of Medicine in 1907. His main interests were in diseases of the diaphragm, lungs, and liver.

Leg paresis

One is a maneuver aimed to separate organic from non-organic paresis of the leg.cite journal |author=Koehler PJ, Okun MS |title=Important observations prior to the description of the Hoover sign |journal=Neurology |volume=63 |issue=9 |pages=1693–7 |year=2004 |month=November |pmid=15534257 |doi= |url=http://www.neurology.org/cgi/pmidlookup?view=long&pmid=15534257] The sign relies on the principle of synergistic contraction. Involuntary extension of the "paralyzed" leg occurs when flexing the contralateral leg against resistance. It has been neglected, although it is a useful clinical test. Essentially, you hold your hand under the contralateral heel and ask the patient to extend the leg off the bed. If you feel pressure from the contralateral heel, the weakness is likely organic. If no pressure is felt, the patient is likely suffering from non-organic limb weakness.

Strong hip muscles can make the test difficult to interpret.cite journal |author=Sonoo M |title=Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb |journal=J. Neurol. Neurosurg. Psychiatr. |volume=75 |issue=1 |pages=121–5 |year=2004 |month=January |pmid=14707320 |pmc=1757483 |doi= |url=http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=14707320]

Efforts have been made to use the theory behind the sign to report a quantitative result.cite journal |author=Ziv I, Djaldetti R, Zoldan Y, Avraham M, Melamed E |title=Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: the quantitative Hoover's test |journal=J. Neurol. |volume=245 |issue=12 |pages=797–802 |year=1998 |month=December |pmid=9840352 |doi= |url=http://link.springer.de/link/service/journals/00415/bibs/8245012/82450797.htm]

Pulmonary

Another Hoover’s sign is inward movement of the lower rib cage during inspiration,cite journal |author=Binazzi B, Bianchi R, Romagnoli I, "et al" |title=Chest wall kinematics and Hoover's sign |journal=Respir Physiol Neurobiol |volume=160 |issue=3 |pages=325–33 |year=2008 |month=February |pmid=18088571 |doi=10.1016/j.resp.2007.10.019 |url=http://linkinghub.elsevier.com/retrieve/pii/S1569-9048(07)00301-1] implying a flat, but functioning, diaphragm, often associated with COPD.cite journal |author=Garcia-Pachon E, Padilla-Navas I |title=Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease |journal=Int. J. Clin. Pract. |volume=60 |issue=5 |pages=514–7 |year=2006 |month=May |pmid=16700846 |doi=10.1111/j.1368-5031.2006.00850.x |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1368-5031&date=2006&volume=60&issue=5&spage=514]

References


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