CLINICAL SIGNS & TESTS

Region: Test / Sign: Description

commemorative any sign of a previous disease.
sign:
antecedent sign: any precursory indication of a malady.
cogwheel jerky motions produced on testing a muscle's strength; the
phenomenon: jerks are neither rhythmic nor equal and represent malingering
or protection from pain; cogwheel s.
somatic sign: any sign presented by trunk or limbs rather than sensory
apparatus.
Dupuytren sign: for determining sarcomatous bone; a crackling sensation on
compression of that area is noted.
Gower sign: for progressive muscular dystrophy and tabes dorsalis; abrupt
intermittent oscillation of iris under light is the indication of
ongoing process.
Hueter sign: for indication of fracture; absence of the transmission of
osseous vibration in fractures as heard by a stethoscope,
where the fibrous material is interposed between the
fragments.
Langer line: the normal tension lines of skin commonly used to define
direction of scar, as to how the scar runs with or across those
lines.
objective sign: one that can be seen, heard, measured, or felt by the
diagnostician to confirm or deny an ongoing symptom;
physical s.
quadriceps test: for hyperthyroidism or debilitating condition; while standing,
the patient is asked to hold leg up and straight out; a disease
is present if patient cannot maintain this position for 1 minute.
Raynaud pallor or blueness of fingers, toes, or nose brought about by
phenomenon: exposure to cold and less commonly by other stresses.
cafe-an-lait for neurofibromatosis; hyperpigmented areas of skin indicate
spots: this ongoing problem; von Recklinghausen disease.
Back Soto-Hall sign: for lesions in back abnormalities; with the patient supine,
flexion of the spine beginning at the neck and going downward
will elicit pain in the area of the lesion.
Back Mennell sign: for spinal problems; examiner's thumb is taken over the
posterosuperior spine of sacrum outward and inward for
noting tenderness, which may be caused by sensitive deposits
in gluteal aspect of posterosuperior spine; ligamentous strain
and sensitivity.
Back Minor sign: for sciatica; patient rises from sitting position, supporting
himself on healthy side, placing hand on back, and bending
affected leg, revealing pain.
Back Naffziger sign: for sciatica or herniated nucleus pulposus; nerve root irritation
is produced by external jugular venous compression by
examiner.
Back Patrick test: for pain in lumbosacral area or hip; see Fabere s. and fadire t.
Back postural fixation: a sign noted on range of motion of the back; any postural
deformity (stiffness) noted does not reverse with range of
motion.
Back spine sign: for poliomyelitis; the patient is unable to flex the spine
anteriorly because of pain.
 Region: Test / Sign: Description
Back sponge test: for detecting lesions of the spine; the examiner passes a hot
sponge up and down the spine, and the patient feels pain over
the lesion.
Back Lasegue straight for determining nerve root irritation; the supine patient
leg raising (SLR) elevates his leg straight until there is back or ipsilateral
test: extremity pain or until the pain is increased with dorsiflexion of
the foot; Lasegue s.
Back Turyn sign: for sciatica; when examiner bends the patient's great toe
dorsally, pain is felt in the gluteal region.
Back Lorenz sign: for ankylosing spondylitis (Marie-Strumpell disease); ankylotic
rigidity of the spinal column, esp. thoracic & lumbar segments.
Back Vanzetti sign: for sciatica; the pelvis is horizontal in the presence of
scoliosis. In other scoliotic conditions the pelvis is inclined.
Back fadire test: forced position of the hip causing pain; the letters stand for
flexion adduction internal rotation in extension; Patrick t., fadir
s.
Back Valsalva for determining nerve root irritability within the spinal canal.
maneuver: This maneuver is also used for many other unrelated reasons.
The patient takes a deep breath and then on bearing down,
such as one does when lifting a heavy object, notes pain.
Back Babinski sign: for testing sciatic nerve pain; also for loss or lessening of the
Achilles tendon reflex in sciatica, distinguishing it from hysteric
sciatica.
Back Abbott method: for scoliosis of the spine; traction is applied to produce
overcorrection, followed by casting.
Back Goldthwaite sign: for distinguishing lumbosacral from sacroiliac pain; with the
patient supine, his leg is raised with one hand, while the
examiner's other hand is placed under the patient's lower
back; leverage is then applied to the side of the pelvis. If pain
is felt by the patient before the lumbar spine is moved, the
lesion is a sprain of the SI joint; if pain is not felt until after the
the lumbar spine is moved, the lesion is in the SI or
lumbosacral articulation.
Back Anghelescu sign: for testing tuberculosis of the vertebrae or other destructive
processes of the spine; in the supine position the patient
places weight on his head and heels while lifting his body
upward; inability to bend the spine indicates an ongoing
disease process.
Back Bekhterev test: for nerve root irritability in sciatica; while sitting up in bed, the
patient is asked to stretch out both legs; with sciatica he
cannot sit up in bed this way, he can only stretch out each leg
in turn.
Back Bragard sign: for nerve or muscular involvement; with the knee stiff, the
lower extremity is flexed at the hip until the patient
experiences pain; the foot is then dorsiflexed. Increase in pain
points to nerve involvement; no increase in pain indicates
muscular involvement. contralateral straight leg raising test:
for sciatica; when the leg is flexed, the hip can also be flexed,
but not when the leg is held straight. Flexing the sound thigh
with the leg held straight causes pain on the affected side;
Fajersztajn crossed sciatic s.
Back Coopernail sign: for fracture of pelvis; ecchymosis of the perineum, scrotum, or
labia indicates a pelvic fracture.
Back Dejerine sign: for symptoms of a herniated nucleus pulposus (HNP); a
 Region: Test / Sign: Description
Valsalva maneuver produces aggravation of symptoms of
radiculitis by coughing, sneezing, and straining at stool.
Back Demianoff sign: for differentiation of pain originating in the lumbosacral muscle
from lumbar pain of any other origin; the pain is caused by
stretching of the lumbosacral muscle.
Back Erichsen sign: for sacroiliac disease; when the iliac bones are sharply
pressed toward each other, pain is felt in the sacroiliac area.
Back FABER sign: for testing lower back or sacroiliac joint disorder by using a
forced position of the hip; the letters stand for flexion
abduction external rotation in extension; Patrick t., faber t.,
figure of 4 t.
Back Gaenslen sign: for lumbosacral disease; pressure on hyperextended thigh
with the hip held in flexion elicits pain, indicating a
lumbosacral problem.
Back Amoss sign: for painful flexure of the spine; pain is produced when the
patient places his hands far behind him in bed and tries rising
from supine position to sitting position.
Feet Helbing sign: for flatfoot; medialward curving of the Achilles tendon as
viewed from behind.
Feet Keen sign: for Pott fracture of the fibula; if fracture exists, there is
increased diameter around the malleoli area of the ankle.
Feet Marie-Foix sign: for central nervous system disorder; withdrawal of the lower
leg on transverse pressure of the tarsus or forced flexion of
toes, even when the leg is incapable of voluntary movement.
Feet Morton test: for metatarsalgia or neuroma; transverse pressure across
heads of the metatarsals causes sharp pain in the forefoot.
Feet Mulder's clunk for Morton neuroma - palbable 'clunk' when compressing the
metatarsal heads in the transverse direction & applying
pressure to the affected web space
Feet Nelson's toe for Morton neuroma; disproportional spreading of the toes,
spread sign: comparing one foot with the other.
Hand prehension: the ability to grasp with the fingers and thumb.
Hand Finkelstein sign: for synovitis; bending the thumb into the palm to determine
synovitis of the abductor pollicis longus tendon to wrist.
Hand pulp pinch: the strength in the position one would use to pick up a piece of
paper.
Hand circumduction a maneuver for the thumb; any general test or motion
maneuver: involving a rotation action of a group of joints; a range of
motion examination.
Hand Allen test: for occlusion of radial or ulnar artery; if compression of one
vessel stops blood supply to the hand, the opposite vessel is
occluded.
Hand Froment paper for ulnar nerve loss; flexion of the distal phalanx of the thumb-
sign: with a sheet of paper held between the thumb and index
finger, the thumb flexes on the side of the index finger.
Hand Wartenberg sign: for ulnar palsy; a sign noting the position of abduction
assumed by the little finger. In describing the functional
capacity of the hand, certain motions are peculiar to that
anatomy. key pinch: the strength in the ability to grasp, as in
holding a key; lateral pinch.
Hand bracelet test: for early rheumatoid arthritis involving the distal radioulnar
joint; compression of the lower ends of the ulna and radius
 Region: Test / Sign: Description
elicits moderate lateral pain.
Hand Fowler maneuver: a maneuver for testing rheumatoid arthritis; tight intrinsic
muscles in ulnar deviation of the digits and a heavy, taut, ulnar
band are demonstrated when the digit is held in its normal
axial relationship.
Hand Kanavel sign: for infection of a tendon sheath; there is a point of maximum
tenderness in the palm 1 inch proximal to the base of the little
finger.
Hand Phalen test and for carpal tunnel syndrome; impingement on the median nerve
maneuver: is determined by holding the wrist flexed or extended for 30 to
60 seconds.
Hand Maisonneuve sign: for Colles fracture; there is marked hyperextensibility of the
hand.
Hip Ortolani sign: for congenital dislocated hip; an audible click is heard when
the hip goes into the socket; noted in infancy; if the sign is
elicited; the dislocation should be corrected at that time to
avoid hip dysfunction later.
Hip Galeazzi sign: for congenital dislocation of the hip; the dislocated side is
shorter when both thighs are flexed to 90 degrees, as
demonstrated in infants; in an older patient a curvature of the
spine is produced by shortened leg.
Hip Jansen test: for osteoarthritis deformans of the hip; the patient is asked to
cross the legs with a point just above the ankle resting on the
opposite knee. If significant disease exists, this test and
motion are impossible.
Hip Langoria sign: for symptoms of intracapsular fracture of the femur; relaxation
of the extensor muscles of the thigh is present.
Hip Leadbetter for slipped capital femoral epiphysis; a maneuver to get the
maneuver: epiphysis in place.
Hip Allis sign: for femoral neck fracture; relaxation of the fascia between the
crest of the ilium and the greater trochanter.
Hip Trendelenburg for muscular weakness in poliomyelitis, ununited fracture of
test: the femoral neck, rheumatoid arthritis, coxa vara, and
congenital dislocations. With the patient standing, weight is
removed from one extremity. If gluteal fold drops on that side,
it signifies muscular weakness of the opposite weight-bearing
hip and weakness of the abductor of the weight-bearing hip.
Also called Trendelenburg sign.
Hip Nelaton line: (x-ray and physical examinations): for detecting dislocation of
the hip; a line from the anterosuperior iliac spine to the ischial
tuberosity, which normally passes through the greater
trochanter.
Hip Ely test: for determining tightness of the rectus femoris or contracture
of the lateral fascia of the thigh; with patient in prone position,
flexion of the leg on the thigh causes buttocks to arch away
and leg to abduct at the hip joint.
Hip anvil test: for early hip joint disease or diseased vertebrae; a closed fist
striking a blow to the sole of the foot with leg extended
produces pain in the hip or vertebrae.
Hip Thomas sign: for hip joint flexion contracture; when the patient is walking,
the fixed flexion of the hip can be compensated by lumbar
lordosis. With the patient supine and flexing the opposite hip,
the affected thigh raises off the table; Striimpell sign., Thomas
 Region: Test / Sign: Description
test.
Hip Chiene test: for determining fracture of the neck of the femur by use of a
tape measure.
Hip piston sign: for congenital dislocation of the head of the femur; if positive,
there is up-and-down movement of the head of the femur;
Dupuytren s.
Hip Desault sign: for intracapsular fracture of the hip; alternation of the arc
described by rotation of the greater trochanter, which normally
describes the segment of a circle but in this fracture rotates
only as the apex of the femur rotates about its own axis.
Hip Ludloff sign: for traumatic separation of the epiphysis of the lesser
trochanter; swelling and ecchymosis are present at the base
of Scarpa triangle, together with inability to raise the thigh
when in sitting position.
Knee Apley test: for differentiating ligamentous from meniscal injury; tibial
rotation on femur with traction or compression with the patient
prone and knee flexed; Apley s.
Knee McMurray for noting joint menisci tears or tags; there is cartilage clicking
circumduction medially or laterally on manipulation of the knee; McMurray s.
maneuver:
Knee bayonet sign: lateral placement of infrapatellar tendon with a valgus knee
produces a bayonet appearance in the quadriceps patellar
tendon complex.
Knee British test: for knee pain and/or injury; compression of patella during
active quadriceps contraction as knee is extended elicits pain.
Knee camelback sign: an unusually prominent infrapatellar fat pad of the knee and
hypertrophy of the vastus lateralis.
Knee double camelback prominence of a high-riding patella and infrapatellar fat pad,
sign: producing the appearance of a camel back.
Knee drawer sign: for ligamentous instability or niptured cruciate ligaments; with
the patient supine and knee flexed to 90 degrees, the sign is
positive if knee is not displaced abnormally in a posterior
direction with knee pulled forward. Also called an anterior
drawer sign, meaning the anterior cruciate is lax or ruptured.
Knee Lachman test: with the patient supine and the knee flexed to 20 degrees, the
tibia is pulled anteriorly. A "give" reaction or mushy end point
indicates a torn anterior cruciate ligament.
Knee patellar for synovitis; compression of patella causes pain when the
retraction test: patient attempts to set the quadriceps muscles with the knee
in full extension.
Knee pivot shift sign: usually sports related; when the knee is brought to full
extension, there is a sudden forward shift of the lateral side of
knee.
Knee Slocum test: for rotatory instability of the knee; the examiner pulls on the
upper calf of a supine patient with the knees flexed 90
degrees.
Knee thumbnail test: for patellar fracture; fracture is felt as a sharp crevice when
the examiner's thumbnail is passed over the subcutaneous
surface of the patella.
Knee grimace test: for knee pain or crepitus; if compression of the patella elicits
pain or crepitus is noted, the patient will grimace.
Lower tourniquet test: for phlebitis of the leg; toumique is applied to the thigh and
Limb pressure gradw increased until the patient complains of pain
 Region: Test / Sign: Description
ir the calf; result is compared with the effect on the Opposite
leg.
Lower anterior tibial sign: for spastic paraplegia; involuntary extension of the tibialis
Limb anterior muscle when thigh is forcibly flexed on the abdomen.
Lower Cleeman sign: for distal fracture of femur with overriding of the fragments;
Limb shows creasing of the skin just above the patella
Lower Homans sign: lower calf examination for thrombophlebitis; discomfort in the
Limb body of the calf on forced passive dorsiflexion of the foot
indicates thrombosis in the leg.
Lower Ober test: for tensor fascia femoris contracture (tightness); if fascia lata
Limb mechanism is tight, knee cannot extend fully when thigh is
abducted.
Lower Payr sign: early sign of impending postoperative thrombosis, indicated by
Limb tenderness when pressure is placed over the inner side of the
foot.
Lower Schlesinger sign: for extensor spasm at the kne joint; with patient's leg held at
Limb the knee joint an flexed strongly at the hip joint, there will
follo~ an extensor spasm at the knee joint with extr~
supination of the foot.
Lower Addis test: for determination of leg length discrepancy; with patient in
Limb prone position, flexing the knees to 90 degrees reveals the
potential discrepancies of both tibial and femoral lengths.
Metabolic Tensilon test: for myasthenia gravis; a chemical test for denoting muscle
strength or weakness; injection of edrophonium chloride
(Tensilon) will reverse the symptoms in patients whose
muscle weakness is caused by myasthenia gravis.
Metabolic Chvostek sign: for determining low serum calcium leading to tetany; tapping
of cheek near the facial nerves causes the muscles to twitch
or go into spasm; Chvostek t., Chvostek-Weiss s., Weiss s.,
Schultze-Chvostek s.
Metabolic lead line: a blue line seen in the gums of a patient with lead poisoning;
Burton s.
Neck Rust sign: for caries or malignant disease of the cervical vertebrae; the
patient supports his head with his hands while moving his
body.
Neck anvil test: for vertebral disorders; a closed fist striking blow on top of the
head elicits pain in the vertebra(e).
Neck Allen maneuver for same diagnosis as Adson in., except the forearm is flexed
at right angle with the arm extended horizontally and rotated
externally at the shoulder, with the head rotated to the
contralateral shoulder.
Neck Adson maneuver for scalenus anticus syndrome, noted on obliteration of radial
pulse; upper limb to be tested is held in dependent position
while head is rotated to the ipsilateral shoulder.
Neck Spurling test: for cervical spine and foraminal nerve encroachment;
compression on the head with extension of the neck causes
radicular pain into the upper extremities.
Neurologic Moro reflex: for testing normal early neurologic development or the failure
to progress neurologically; the infant is placed on a table, then
the table is forcibly struck from either side, causing the infant's
arms to be thrown out as in an embrace; should disappear as
infancy progresses.
Neurologic pronation sign: for central nervous disorders; there is a strong tendency for
 Region: Test / Sign: Description
the forearm to pronate; Strumpell s.
Neurologic Leichtenstern for cerebrospinal meningitis; tapping lightly on any bone of the
sign: extremities causes patient to wince suddenly.
Neurologic Len sign: for hemiplegia; passive flexion of the hand and wrist of the
affected side shows no normal flexion at the elbow.
Neurologic Lhermitte sign: for cervical cord injuries or cord degeneration; transient
dysesthesia and weakness are noted in all four limbs when
the patient flexes the head forward.
Neurologic long tract sign: any sign that one would see in affection of either sensory or
motor tracts in the spinal cord; Babinski reflex, Romberg t.
Neurologic Mendel-Bekhterev for organic hemiplegia; using a percussion hammer, the
reflex: examiner notes flexion of the small toes if the dorsal surface
of the cuboid bone is struck.
Neurologic Morquio sign: for epidemic poliomyelitis; the supine patient resists attempts
to raise trunk to a sitting position until the legs are passively
flexed.
Neurologic Piotrowski sign: for organic disease of the central nervous system; percussion
of tibialis muscle produces dorsiflex ion and supination;
anticus sign or reflex.
Neurologic pseudo-Babinski in poliomyelitis the Babinski reflex is modified so only the big
sign: toe is extended, because all foot muscles except dorsiflexors
of the big toe are paralyzed.
Neurologic Queckenstedt for detecting a block in the vertebral canal; compression of
sign: veins in the neck on one or both sides produces rapid rise in
pressure of cerebral spinal fluid of a healthy person and
quickly disappears. But in a patient with blockage in vertebral
canal, pressure of cerebrospinal fluid is little or not at all
affected by this sign.
Neurologic radialis sign: for nerve impairment; inability to close the fist without marked
dorsal extension of the wrist; Strumpell s.
Neurologic Raimiste sign: for paretic condition; patient's hand and arm are held upright
by examiner; a sound hand remains upright on being
released, but a paretic hand flexes abruptly at the wrist.
Neurologic Romberg test: for differentiation between peripheral and cerebellar ataxia;
increase in clumsiness in movements and in width and
uncertainty of gait when patient's eyes are closed indicate
peripheral ataxia; no change indicates cerebellar type. (NOTE:
Romberg sign is similar in testing but used for noting tabes
dorsalis.)
Neurologic Sarhb sign: for locomotor ataxia; analgesia of peroneal nerve is noted.
Neurologic Schreiber for patellar reflex testing; rubbing the inner side of the upper
maneuver: part of thigh enhances the reflex.
Neurologic stairs sign: in locomotor ataxia there is difficulty or failure of ability to
descend stairs.
Neurologic station test: for coordination disturbance; feet are planted firmly together; if
the body sways, lack of coordination is indicated.
Neurologic tendon reflexes: for testing continuity of normal muscle to spinal cord to muscle
reflex arc. Any tendon may be so tested, but the most
common are the deep tendon reflexes (DTRs):
Neurologic Oppenheim sign: for pyramidal tract disease; dorsal extension of the big toe is
present when the medial side of the tibia is stroked in a
downward direction.
 Region: Test / Sign: Description
Neurologic Huntington sign: for lesions of the pyramidal tract; patient is supine, with legs
hanging over the examining table, and is asked to cough; if
coughing produces fiexion of the thigh and extension of the
leg in the paralyzed limb, a lesion is indicated.
Neurologic contralateral sign: see Brudzinski s.
Neurologic doll's eyes sign: for testing normal or abnormal brain function; the normal
coordinated eye motions seen when passively turning the
head of an unconscious patient; Cantelli s.
Neurologic Ely test: for L-3 and L-4 nerve root irritation; flexing thigh with patient
prone causes back and/or thigh pain; femoral nerve stretch t.,
Ely s.
Neurologic fan sign: for central nerve problems; stroking the sole of the foot with a
needle causes toes to spread; part of Babinski reflex
examination.
Neurologic finger to nose for cerebellar disease; when the patient attempts to put a
test: finger on his nose and then to the examiner's finger, back and
forth rapidly, any incoordination indicates test to be positive.
Neurologic Fournier test: for determining ataxic gait; it is noted with the patient moving
about abruptly in walking, starting, and stopping.
Neurologic Frankel sign: for tabes dorsalis; noted by diminished tonicity of muscles
about the hip joint.
Neurologic Guilland sign: for meningeal irritation; when the contralateral quadriceps
muscle group is pinched, there is brisk flexion at the hip and
knee joint.
Neurologic tibialis sign: for spastic paralysis of the lower limb; there is dorsiflex ion of
the foot when the thigh is drawn toward the body; tibial
phenomenon.
Neurologic Hoffmann sign: for testing digital reflex; nipping of three fingernails (index,
middle, ring) produces flexion of terminal phalanx of thumb
and second and third phalanx of some other finger; digital
reflex. Indicative of a cervical myelopathy
Neurologic Babinski reflex: for loss of brain control to lower extremities; scraping the soles
causes toes to pull up; Babinski s.
Neurologic Jendrassik to enhance a patellar reflex; the reflex is tested when the
maneuver: patient hooks hands together with flexed fingers and pulls
apart as hard as possible.
Neurologic Kernig sign: for meningitis; in dorsal decubitus, the patient can easily and
completely extend the leg; in sitting or lying down with thigh
flexed upon the abdomen the leg cannot be completely
extended.
Neurologic Kerr sign: for spinal cord lesions; alteration of the texture of the skin
below the somatic level in eliciting location of lesions.
Neurologic Brudzinski sign: for meningitis; flexion of the neck forward results in flexion of
the hip and knee; when passive flexion of the lower limb on
one side is made, a similar movement will be seen in the
opposite limb; neck s., contralateral s.
Neurologic Thomas sign: for cord lesions; pinching of the trapezius muscle causes
goose bumps above the level of the cord lesion.
Neurologic Beevor sign: for functional paralysis; excursion of the umbilicus occurs
when the patient attempts to sit up.
Neurologic Tinel sign: for noting a partial lesion or beginning regeneration of a nerve;
tingling sensation of the distal end of a limb when percussion
is made over the site of divided nerve as in carpal tunnel
 Region: Test / Sign: Description
impingement on the median nerve of the hand; formication s.,
distal tingling on percussion (DTP) s
Neurologic Chaddock sign: for upper motor neuron loss (brain); the big toe extends when
irritating the skin in the external malleolar region; indicates
lesions of the corticospinal paths; external malleolus s.,
Chaddock reflex.
Neurologic Hirschberg sign: for pyramidal tract disease; internal rotation and adduction of
foot on rubbing inner lateral side.
Shoulder Callaway test: for dislocation of the humerus; the circumference of the
affected shoulder measured over the acromion and through
the axilla is greater than that on the opposite, unaffected side.
Shoulder Codman sign: for rupture of the supraspinatus tendon; the arm can be
passively abducted without pain, but when support of the arm
is removed and the deltoid muscle contracts suddenly, pain
occurs again.
Shoulder Comolli sign: for scapular fracture; shortly a injury, there is triangular
swelling, reproduci the shape of the body of the scapula.
Shoulder Dawbarn sign: for acute subacromial bursiti with arm hanging by side,
palpation over t. bursa causes pain; when the arm is pain
disappears.
Shoulder Dugas test: for dislocation of the shoulder; placing hand of affected side
on opposite shoulder bringing elbow to side of chest, a
dislocation may be present if the patient's elbow will touch
side of his chest; Dugas s.
Shoulder Hamilton test: for luxated shoulder; a rod applied to the humerus can be
made to touch the lateral epicondyle and acromion at the
same time to determine a dislocation.
Shoulder Kocher for reducing anterior dislocations of the shoulder; done by
maneuver: abducting arm, externally rotating, adduction, and then
internally rotating.
Shoulder Bryant sign: for dislocation of the shoulder with lowering of the axillary
folds, as noted on visual examination.
Upper Laugier sign: for a displaced distal radial fracture; condition in which the
Limb styloid process of radius and ulna are on same level.
Upper Mills test: for tennis elbow; with wrist and fingers fully flexed and the
Limb forearm pronated, complete extension of the elbow is painful.