Spine
Neurological
Evidence: confirmed
Hoffmann's Sign Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for Cervical Myelopathy or Upper Motor Neuron (UMN) lesions.
How to Perform
- Action: Examiner supports the patient's hand and flicks the nail of the middle finger downward.
Interpretation of Results
- Positive Test: Involuntary flexion (clawing) of the index finger and thumb.
- Meaning: Indicates spinal cord compression or brain lesion.
Diagnostic Accuracy
- Sensitivity: 58%
- Specificity: 78%
Clinical Context & Limitations
The Hoffmann's Sign should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Hoffmann's Sign with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
