Homans sign

In medicine, Homans' sign or the Homans sign was used as a sign of deep vein thrombosis (DVT). A positive sign (test) is present when there is pain in the calf on forceful and abrupt dorsiflexion of the patient's foot at the ankle while the knee is extended. It is named for the American physician John Homans.

It is not a commonly used test. It has fallen out of favor because a positive sign does not indicate DVT (Likelihood ratio positive = 1) and a negative sign does not rule it out (Likelihood ratio negative = 1). It is estimated to have a sensitivity of 60-88% and a specificity of 30-72%.

Other tests for DVT include an ultrasound of the effected leg, or to have a blood test done (D-dimer, which is sensitive but not specific for DVT, as it is elevated for many other reasons), both of which are a better choice to rule out blood clots than the Homans' sign.

Modern medical texts such as the Oxford Handbook of Clinical Medicine (8th Ed.) state that this sign should not be elicited as the risk of dislodging the thrombus is significant, leading to the potential development of a pulmonary embolism.

Even so, it is thought that the belief that eliciting Homan's sign is dangerous is mistaken; this concern is based upon a single case of pulmonary thromboembolism following calf pressure during an examination.