Deep vein thrombosis: Homan's sign was not useful in diagnosing DVT.

Clinical bottom line (level 4)

  1. Homan's sign was unhelpful in diagnosing deep vein thrombosis.
Cranley et al: Archives of Surgery 1976; 111 (1): 34-36
Expires August 2003

The study

Setting: tertiary medical centre, USA

124 patients (aged ?, ?% male) referred by primary-care physician with suspected deep vein thrombosis

Independent unblinded reference standard, applied in all patients from a non-consecutive appropriate spectrum.
Reference standard:
  • venography
Diagnostic test: Homan's sign: positive if no dorsiflexion of the foot, on squeezing the calf muscle
  • Many patients were excluded on the basis of another diagnosis confirmed, superficial thrombophlebitis or postphlebitic syndrome

The evidence

pre-test probability of deep vein thrombosis: 57%, (95% CI: 47% to 66%)

diagnostic test deep vein thrombosis no DVT LR+
(95% CI)		 post-test probability LR-
(95% CI)		 post-test probability
positive 28 18 1.2
(0.76 to 1.9) 		61% 0.88
(0.62 to 1.2) 		53%
total 59 45

  • Muscle pain, tenderness and swelling were also unhelpful

Citation

  1. Cranley JJ, Canos AJ, Sull WJ: The diagnosis of deep venous thrombosis. Fallibility of clinical symptoms and signs. Archives of Surgery 1976; 111 (1): 34-36
Contributor: Bob Phillips and Clare Wotton, August 2000
Reviewer: Alex Gallus

Clinical Question.
Patient suspected DVT
Intervention or Exposure Homan's sign
Outcome diagnosis