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
ANSWER
C. Ovarian tumor.
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.
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.
Q1. What condition is Hingorani sign primarily used to diagnose?
👉 Hingorani sign indicates deep vein thrombosis (DVT) when passive plantar flexion of toes produces dorsal foot pain.
Q2. How is Hingorani sign elicited?
👉 Hingorani sign is elicited by passive plantar flexion of toes, which stretches inflamed veins in DVT.
Q3. Pain in Hingorani sign is typically localized where?
👉 A positive Hingorani sign produces pain on the dorsum of the foot.
Q4. Hingorani sign is considered a:
👉 Hingorani sign is a clinical bedside sign to raise suspicion for DVT.
Q5. Which diagnostic method confirms DVT after Hingorani sign is suspected?
👉 DVT is confirmed using venous Doppler ultrasound, not just clinical signs.
Q6. Hingorani sign is considered:
👉 Hingorani sign is non-specific and should be supplemented with imaging.
Q7. Hingorani sign may be confused with:
👉 Hingorani sign is one among several bedside signs of DVT, similar to Homan’s and Moses signs.
Q8. What clinical movement reproduces Hingorani sign pain?
👉 Hingorani sign pain is reproduced by toe plantar flexion.
Q9. Who described Hingorani sign?
👉 The sign is named after Hingorani, who first described it for DVT detection.
Q10. Which type of DVT is Hingorani sign most useful for?
👉 Hingorani sign is more often positive in distal lower limb vein thrombosis.
Q11. Hingorani sign is best classified as:
👉 Hingorani sign is a physical examination maneuver for DVT.
Q12. Which feature reduces reliability of Hingorani sign?
👉 Hingorani sign has low specificity for DVT.
Q13. A positive Hingorani sign suggests:
👉 A positive Hingorani sign raises suspicion of DVT.
Q14. Which other sign also uses pain as diagnostic clue in DVT?
👉 Homan’s sign also elicits pain in suspected DVT.
Q15. What is the main drawback of Hingorani sign?
👉 Hingorani sign lacks both sensitivity and specificity.
Q16. Hingorani sign is most helpful in which setting?
👉 It is mainly useful as a bedside clinical suspicion tool for DVT.
Q17. Hingorani sign involves stretching of:
👉 Pain arises due to stretching inflamed veins of lower limb with thrombus.
Q18. Hingorani sign is mainly tested in which patient position?
👉 Hingorani sign is usually tested with the patient in a supine position.
Q19. Which of the following reduces utility of Hingorani sign in modern practice?
👉 With modern imaging like Doppler ultrasound, Hingorani sign is rarely used.
Q20. Hingorani sign is now considered:
👉 Hingorani sign is a historical bedside sign, not widely relied upon today.
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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