Positive Homan's sign is associated with the presence of?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

Homan's sign refers to calf pain experienced upon forced dorsiflexion of the foot.
This sign is historically associated with the presence of a blood clot in the deep veins of the leg, a condition known as Deep Vein Thrombosis (DVT).
The pain is believed to result from stretching the inflamed tissues around the thrombus.
Although it is a classic sign, it is now considered unreliable for diagnosing DVT due to its low sensitivity and specificity, as pain can be caused by other musculoskeletal issues.

Option A: Nystagmus is the involuntary, rhythmic movement of the eyeballs. It is a sign of a neurological or vestibular (inner ear) disorder, not venous thrombosis.
Option C: Deafness is the partial or complete loss of hearing. It relates to the auditory system and has no physiological connection to blood clots in the leg veins.
Option D: Capillary fragility causes easy bruising and petechiae (small red or purple spots) due to weak blood vessel walls. It is not a sign of DVT, which involves clot formation within a vein.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical assessment for Deep Vein Thrombosis (DVT) as background academic context rather than a clinical decision trigger.
Nurses must recognize that Homan's sign is an unreliable indicator of DVT. A negative sign does not rule out DVT, and a positive sign requires confirmation with more definitive tests.
The gold standard for diagnosing DVT is a venous duplex ultrasound, which provides a visual of the blood flow and can identify clots.
A critical nursing priority for a patient with suspected or confirmed DVT is to monitor for signs of a pulmonary embolism (PE), a life-threatening complication. Key signs include sudden onset of dyspnea, chest pain, tachycardia, and anxiety.

How to Approach the Question

This is a factual recall question that tests your knowledge of a specific clinical sign.
Identify the key term in the question stem: 'Homan's sign'.
Recall the definition and clinical association of this sign. Homan's sign is calf pain on dorsiflexion of the foot.
Connect this sign to its corresponding medical condition, which is Deep Vein Thrombosis (DVT).
Evaluate the given options. 'Thrombosis' is the correct pathological process.
Systematically eliminate the other options by confirming they are unrelated: Nystagmus (eyes), Deafness (ears), and Capillary fragility (easy bruising).

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 521-523

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