Digiti quinti sign for hemiparesis

Patients: Sixty patients with unilateral brain tumors without obvious focal signs and 30 controls

Examination: A physical therapist, blinded to all clinical and  imaging data, performed 13 clinical tests. A photograph of the digiti quinti sign is at http://pubmed.gov/20799429. In this test, the patient extends arms as for the pronator drift test, but turns palms down. In an abnormal test, the 5th finger on the weak side abducts more than the 5th finger on the normal side.

Outcome: MRI

Results:

Selected results from 13 tests that were studied.
Test Sensitivity Specificity
Digiti quinti sign 51% (41-61) 70% (61-79)
Pronator drifting test 41% (31-51) 96% (92-99)
Babinski sign 8%(2-14) 100%

Comment: this study used a case control design and so is subject to spectrum bias. However, restricting all patients to those without obvious focal signs may somewhat compensate.

This has been added to http://en.citizendium.org/wiki/Digiti_quinti_sign

Citation

Maranhão ET, Maranhão-Filho P, Lima MA, & Vincent MB (2010). Can clinical tests detect early signs of monohemispheric brain tumors? Journal of neurologic physical therapy : JNPT, 34 (3), 145-9 PMID: 20799429

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s


%d bloggers like this: