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Contents loading... Editors loading... Categories loading... When refering to evidence in academic writing, you should always try to reference the primary (original) source. That is usually the journal article where the information was first stated. In most cases Physiopedia articles are a secondary source and so should not be used as references. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Purpose[edit | edit source]Homan’s sign test also called dorsiflexon sign test is a physical examination procedure that is used to test for Deep Vein Thrombosis (DVT). A positive Homan’s sign in the presence of other clinical signs may be a quick indicator of DVT. Clinical evaluation alone cannot be relied on for patient management, but when carefully performed, it remains useful in determining the need for additional testing (like D-dimer test, ultrasonography, multidetector helical computed axial tomography (CT), and pulmonary angiography) [1][2]. Technique[edit | edit source]
[3] Evidence[edit | edit source]Passive, abrupt and forced ankle dorsiflexion with slight knee flexion causes mechanical traction on the posterior tibial vein. This traction stimulates the pain sensitive structures in the lower limb [4] [5]. Differential diagnosis of conditions that demonstrate a positive Homan’s sign include intervertebral disc herniation, ruptured Baker’s cyst, neurogenic claudication, gastrocnemius spasm, and cellulitis [6]. Accuracy[edit | edit source]Homan’s sign has low sensitivity and specificity in diagnosing DVT; it can be of value if used in addition to more accurate diagnostic procedures like ultrasonography and venography[7]. Precaution[edit | edit source]Vigorous dorsiflexion of the foot is used by surgeons to expel clot from the veins and so this test may have its dangers[8]. Common Errors[edit | edit source]A common error that may occur is the examiner not dorsiflexing the patient’s foot enough to get a correct interpretation. The knee of the patient must also be in full extension. Relevance to Physiotherapists[edit | edit source]Homan’s sign test may serve as a quick and easy way to determine if a patient might be having a DVT and subsequently exercise caution when carrying out certain movements involving the lower limb especially in bedridden and unconscious patients. References[edit | edit source]
When assessing the presence of deep vein thrombosis which clinical manifestations should the nurse expect to be present select all that apply?Signs and symptoms of a DVT include: redness, swelling, warm extremity, pain, positive Homan's Sign, and swelling (which can be unilateral… meaning there is more swelling in one extremity compared to the other).
What are the clinical manifestations of thrombosis?Thrombosis occurs when blood clots block veins or arteries. Symptoms include pain and swelling in one leg, chest pain, or numbness on one side of the body. Complications of thrombosis can be life-threatening, such as a stroke or heart attack.
What are signs that a client might have a deep vein thrombosis?DVT symptoms
pain, swelling and tenderness in one of your legs (usually your calf or thigh) a heavy ache in the affected area. warm skin in the area of the clot. red skin, particularly at the back of your leg below the knee.
How does a nurse assess for a deep vein thrombosis?The D-dimer test is sometimes done in primary care by the assessing nurse but can also be done in hospital. Patients with a likely two-level Wells DVT score (two points or above) should have a proximal leg vein ultrasound scan (USS) within four hours. If the result is negative, a D-dimer test should be performed.
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