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What is the Hoffmann sign used for?

The Hoffmann sign is used by examiners assessing patients with symptoms of myelopathy (spinal cord compression). The test is done by quickly snapping or flicking the patient’s middle fingernail. The test is positive for spinal cord compression when the tip of the index finger, ring finger, and/or thumb suddenly flex in response.

What is a positive Hoffmann's sign in normal patients?

A positive Hoffmann's sign in the normal patients is more commonly found in those who are naturally hyper-reflexive (e.g. 3+ reflexes). A positive Hoffmann's sign is a worrisome finding of a disease process if its presence is asymmetrical, or has an acute onset.

What does bilateral Hoffmann sign mean?

Bilateral Hoffmann sign in patients with low back pain was strongly linked with unknown compression of the cervical cord. Therefore the Hoffmann sign is a reliable way to test for early signs of cervical myelopathy. The presence of Hoffmann sign on both sides strongly suggests the presence of spinal cord compression in the cervical spine.

How do you test for Hoffmann's sign?

Perform a sharp and forceful flick of your thumb, making contact with the nail of the subject’s middle finger. The subject's finger will flex immediately followed by relaxation. The presence of Hoffmann's sign is characterized by flexion and adduction of the thumb and flexion of the index finger.

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