Ankle & Foot
Neurological & Vascular
Evidence: uncertain
Homans Sign Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for Deep Vein Thrombosis (DVT).
How to Perform
- Position: Patient lies on their back with the knee straight (extended).
- Action: Passively push the foot up (dorsiflexion).
- Repeat: Perform the same movement with the knee bent (flexed).
Interpretation of Results
- Positive Test: Deep pain in the calf muscle.
- Warning: The book notes this test is nonspecific and unreliable; positive signs can occur with other conditions.
Diagnostic Accuracy
- Poor sensitivity and specificity.
Clinical Context & Limitations
The Homans 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 Ankle & Foot region, combining the Homans Sign with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.
