A 74-year-old patient was delivered into admission room with clinical presentations of acute deep vein thrombosis of the shin. What symptom is the most typical of this pathology?

Answer options

1. Mayo-Robson’s sign
2. Courvoisier’s sign
3. Homan’s sign
4. Grey Turner’s sign
5. Rovsing’s sign

Explanation

Homans’ sign is often used in the diagnosis of deep venous thrombosis of the leg. A positive Homans’ sign (calf pain at dorsiflexion of the foot) is thought to be associated with the presence of thrombosis. Clinical examination for DVT is unreliable. Physical signs may also be absent. Mild pitting edema of the ankle, dilated surface veins, a stiff calf, and tenderness over the course of the deep veins should be sought. Leg pain occurs in about 50 % of patients with DVT but is nonspecific. Homans’ sign – resistance (not pain) of the calf muscles to forcible dorsiflexion – is not specific and should not be elicited. Tenderness occurs in 75 % of patients but is also found in 50 % of patients without objectively confirmed DVT. The pain and tenderness associated with DVT do not usually correlate with the size, location, or extent of the thrombus. Bailey & Love’s short practice of surgery. – 27th edition. – P. 988.