Hingorani sign
Hingorani Sign
- Definition: The Hingorani sign refers to dorsal foot pain reproduced on passive plantar flexion of the toes.
- Clinical Use: It is used as a clinical indicator of deep vein thrombosis (DVT) in the lower limb.
- Mechanism: Passive plantar flexion of the toes stretches inflamed veins in the calf, reproducing pain if thrombophlebitis or DVT is present.
- Comparison:
- Similar in principle to Homan’s sign (calf pain on forced dorsiflexion of the ankle), but Hingorani’s is elicited by toe plantar flexion.
- Hingorani sign is sometimes considered more sensitive than Homan’s sign.
Hingorani sign is useful to differentiate which of the following condition in pregnancy:
A. Tubal Pregnancy
B. Molar Pregnancy
C. Ovarian tumor
D. Red degeneration of fibroid
Hingorani sign is used to differentiate between Ovarian Tumor and polyhydramnios or late gravid uterus.
Ovarian tumor – abdominal examaiton reveals the cystic swelling felt separated from gravid uterus. In later month of pregnancy confusion may arise.
The pt is examined vaginally in head down deep trendelenburg position to elicit the groove between the two swelling i.e. gravid uterus and the ovarian tumor.
This is known as hingorani sign.
| Point | Important Fact about Hingorani Sign |
|---|---|
| 1 | Hingorani sign is a clinical test for deep vein thrombosis (DVT). |
| 2 | It is elicited by passive plantar flexion of the toes. |
| 3 | Positive test produces dorsal foot pain. |
| 4 | It indicates venous inflammation or thrombosis. |
| 5 | The test is considered supportive, not diagnostic. |
| 6 | Best used as part of clinical suspicion for DVT. |
| 7 | Hingorani sign is less commonly taught than Homan’s sign. |
| 8 | It has low sensitivity and specificity. |
| 9 | False positives may occur in musculoskeletal pain. |
| 10 | False negatives occur in early or asymptomatic DVT. |
| 11 | Clinical signs like Hingorani sign should be combined with D-dimer and ultrasound. |
| 12 | Ultrasound with Doppler remains the gold standard for DVT diagnosis. |
| 13 | Hingorani sign may sometimes be painful for the patient. |
| 14 | A negative Hingorani sign does not rule out DVT. |
| 15 | It is mainly of historical and academic interest today. |
| 16 | Still useful in resource-limited settings without imaging. |
| 17 | Helps differentiate DVT pain from superficial thrombophlebitis. |
| 18 | Named after vascular surgeon Hingorani who described it. |
| 19 | Rarely used in isolation in modern vascular practice. |
| 20 | Important for medical exams and viva questions. |
Short Questions & Answers – Hingorani Sign
Q1. What does a positive Hingorani sign indicate?
Ans: Suggests the presence of deep vein thrombosis (DVT).
Q2. How is the Hingorani sign tested?
Ans: By passive plantar flexion of the toes.
Q3. What symptom makes the test positive?
Ans: Dorsal foot pain reproduced during the maneuver.
Q4. Is the test diagnostic for DVT?
Ans: No, it is supportive but not definitive.
Q5. Which modern investigation has replaced it?
Ans: Doppler ultrasound of the leg veins.
Q6. Can Hingorani sign give false positives?
Ans: Yes, in musculoskeletal pain or neuropathy.
Q7. Does a negative test exclude DVT?
Ans: No, DVT can still be present.
Q8. In what setting is it still useful?
Ans: Resource-limited settings without imaging.
Q9. What is the key limitation?
Ans: Poor sensitivity and specificity for DVT.
Q10. Why is it important to study Hingorani sign?
Ans: For academic knowledge and exam preparation.
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