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


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


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


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