What are positive homan’s sign?

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Deep vein thrombosis, or DVT, is the formation of blood clots in the deep veins of the body. While DVT itself is not life-threatening, serious, potentially life-threatening complications can occur if it is not promptly and properly treated.

If it is suspected that you have DVT, your healthcare provider may administer a quick test known as the Homan’s Sign Test. Learn more about this easily administered test for DVT

What is the homan’s sign test?

Sometimes referred to as a dorsiflexion sign test, this physical examination is a quick and easy way for healthcare professionals to check for deep vein thrombosis.

How is the homan’s sign test performed?

The Homan’s Sign Test is performed by having you sit on the side of the exam table with both legs hanging down. The examiner will stand in front of you and have you extend your leg by straightening the knee. While the leg is straightening, the examiner will move your foot into dorsiflexion.

With the leg extended and the foot in dorsiflexion, the examiner will gently tap or apply pressure to the calf. If you experience pain or any type of tenderness, the examiner will determine that you have a positive homan’s sign test.

How accurate is the homan’s sign test?

The Homan’s Sign Test can assist a healthcare professional in making a diagnosis of DVT, but it should not be relied upon as the sole test used to make a diagnosis. Other forms of testing such as venography or ultrasonography need to be performed in order to confirm a diagnosis of DVT.

Some of the reasons why the Homan’s Sign Test should not be used as the only method to diagnose DVT include:

  • Not all patients with DVT test positive on the Homan’s Sign Test – a recent study published in Genesis, Pathophysiology and Management of Venous and Lymphatic Disorders discovered that only 30% of individuals with a confirmed DVT diagnosis also had a positive Homan’s Sign test.
  • Some patients have a positive Homan’s Sign Test, but no DVT – the same study that showed only 30% of patients with DVT had a positive Homan’s Test also showed that more than 50% of those that had a positive Homan’s Test did not have DVT.
  • Unreliable if not performed correctly – if the test is not properly administered, such as the knee if not fully extended or the foot is not in proper dorsiflex, it can lead to inaccurate results from the Homan’s Sign Test
  • Patients can misinterpret pain – sometimes patients can interpret the feeling of a stretch, which occurs during the Homan’s Sign Test, as pain. This can result in a false positive Homan’s Sign Test as the patient is experiencing no pain, but instead is feeling a stretch.
  • Other causes of pain can interfere with the test – the Homan’s Sign Test doesn’t take into account other causes of pain such as bruises or a pulled muscle. These can cause a patient to experience pain during a Homan’s Sign Test.

Even though the Homan’s Sign Test can’t be used to confirm a diagnosis of DVT, it is helpful in providing healthcare professionals with a quick and easy way to determine if additional testing is needed.

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