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In medicine, Homans' sign (sometimes spelled as Homans sign) or the dorsiflexion sign is considered a sign of deep vein thrombosis (DVT). It was defined by John Homans in 1941 as discomfort behind the knee on forced dorsiflexion of the foot. After surgeons discovered many examples of a false-positive Homans' sign, Homans redefined it in 1944, stating that "discomfort need have no part in the reaction.", including increased resistance, involuntary flexure of the knee or pain in the calf to forced dorsiflexion as positive responses.[needs update]
It is estimated to have a sensitivity of 10-54% and a specificity of 39-89%, and is thus considered to have no diagnostic value, since a positive sign does not indicate DVT and a negative sign does not rule it out. Still, it is widely used in clinical practice, probably because of its historical role prior to the availability of more reliable diagnostic studies (such as a D-dimer titration or a Doppler ultrasound), as well the ease of eliciting it. Signs and symptoms of DVT in general are not sufficiently sensitive or specific to make a diagnosis, being helpful only to help determine the likelihood of a DVT (with the use of a clinical prediction rule such as the Wells score).
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