It has fallen out of favor because a positive sign does not indicate DVT (Likelihood ratio positive = 1) and a negative sign does not rule it out (Likelihood ratio negative = 1)  It is estimated to have a sensitivity of 60-88% and a specificity of 30-72%.
A positive sign is present when there is pain in the calf on forceful and abrupt dorsiflexion of the patient's foot at the ankle while the knee is extended.
This is not a commonly used test and should not be done at home. This test is less used today because it can potentially dislodge the deep vein thrombosis (DVT) and travel to the lung. The other test for a DVT is to have a blood test done and an ultrasound of the leg, which are both a better choice to rule out blood clots than the Homans' sign.
There is a mistaken belief that eliciting Homan's sign is dangerous; this concern is based upon a single case of pulmonary thromboembolism following calf pressure during a Doppler examination.
- S McGee. Evidence Based Physical Diagnosis. Elsevier, 2012. Chapter 54
- Marx et al., Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th Ed. Elsevier, 2010. Chapter 86
- Homan's sign in gpnotebook. In turn citing: 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.
- Shafer N, Duboff S. Physical signs in the early diagnosis of thrombophlebitis. Angiology 1980;22:18–30.
- Homans' sign at Who Named It?
|This medical sign article is a stub. You can help Wikipedia by expanding it.|