Trousseau sign of latent tetany: Difference between revisions
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{{Infobox medical condition |
{{Infobox medical condition |
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|image = Trousseau |
|image = Trousseau's Sign of Latent Tetany.jpg |
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|caption = The flexed wrist and [[metacarpophalangeal joint]], and the extended [[Distal interphalangeal joint|distal]] and [[proximal interphalangeal joint]] are characteristic of Trousseau sign of latent tetany. |
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|specialty = <!--from Wikidata; can be overwritten--> |
|specialty = <!--from Wikidata; can be overwritten--> |
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|differential = low calcium |
|differential = low calcium |
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'''Trousseau sign of latent tetany''' is a [[medical sign]] observed in patients with low [[calcium]].<ref>Kumar, Abbas, Fausto. ''Pathologic Basis of Disease, 7th edition.'' Philadelphia: Elsevier-Saunders, 2005. 1188.</ref> From 1 to 4 percent of normal patients will test positive for Trousseau's sign of latent tetany.<ref>{{cite book|author=Dennis, Mark|author2=Bowen, William Talbot|author3=Cho, Lucy|chapter=Trousseau's sign|chapter-url=https://books.google.com/books?id=FIV-NYPRCzEC&pg=PA555|title=Mechanisms of Clinical Signs|year=2012|publisher=Elsevier|page=555|isbn=978-0729540759|postscript=; pbk}}</ref> This sign may be positive before other manifestations of [[hypocalcemia]] such as [[hyperreflexia]] and [[tetany]], as such it is generally believed to be more [[Sensitivity and specificity#Sensitivity|sensitive]] (94%) than the [[Chvostek sign]] (29%) for hypocalcemia.<ref name="pmid4952674">{{cite journal|last=Fonseca|first=OA|author2=Calverley, JR |title=Neurological manifestations of hypoparathyroidism.|journal=Archives of Internal Medicine|date=August 1967|volume=120|issue=2|pages=202–6|doi=10.1001/archinte.1967.00300020074009|pmid=4952674}}</ref><ref>Schaat M, Payne CA. Effect of diphenylhydantoin and phenobarbital on latent tetany</ref> |
'''Trousseau sign of latent tetany''' is a [[medical sign]] observed in patients with low [[calcium]].<ref>Kumar, Abbas, Fausto. ''Pathologic Basis of Disease, 7th edition.'' Philadelphia: Elsevier-Saunders, 2005. 1188.</ref> From 1 to 4 percent of normal patients will test positive for Trousseau's sign of latent tetany.<ref>{{cite book|author=Dennis, Mark|author2=Bowen, William Talbot|author3=Cho, Lucy|chapter=Trousseau's sign|chapter-url=https://books.google.com/books?id=FIV-NYPRCzEC&pg=PA555|title=Mechanisms of Clinical Signs|year=2012|publisher=Elsevier|page=555|isbn=978-0729540759|postscript=; pbk}}</ref> This sign may be positive before other manifestations of [[hypocalcemia]] such as [[hyperreflexia]] and [[tetany]], as such it is generally believed to be more [[Sensitivity and specificity#Sensitivity|sensitive]] (94%) than the [[Chvostek sign]] (29%) for hypocalcemia.<ref name="pmid4952674">{{cite journal|last=Fonseca|first=OA|author2=Calverley, JR |title=Neurological manifestations of hypoparathyroidism.|journal=Archives of Internal Medicine|date=August 1967|volume=120|issue=2|pages=202–6|doi=10.1001/archinte.1967.00300020074009|pmid=4952674}}</ref><ref>Schaat M, Payne CA. Effect of diphenylhydantoin and phenobarbital on latent tetany</ref> This sign may also be observed as a symptom of [[hyperventilation syndrome]] as a result of [[hypocapnia]]-induced reduction of calcium levels in the blood.<ref>{{Cite web |title=Hyperventilation Syndrome Clinical Presentation: History, Physical Examination |url=https://emedicine.medscape.com/article/807277-clinical?form=fpf |access-date=2024-05-24 |website=emedicine.medscape.com}}</ref> |
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To elicit the sign, a [[blood pressure cuff]] is placed around the arm and inflated to a pressure greater than the [[systolic blood pressure]] and held in place for 3 minutes. This will occlude the [[brachial artery]]. In the absence of blood flow, the patient's hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and [[metacarpophalangeal joint]]s flex, the [[distal interphalangeal joint|DIP]] and [[proximal interphalangeal joint|PIP]] joints extend, and the fingers [[adduction|adduct]]. The sign is also known as '''''main d'accoucheur''''' ([[French language|French]] for "''hand of the [[obstetrician]]''") because it supposedly resembles the position of an obstetrician's hand in delivering a baby.{{ |
To elicit the sign, a [[blood pressure cuff]] is placed around the arm and inflated to a pressure greater than the [[systolic blood pressure]] and held in place for 3 minutes. This will occlude the [[brachial artery]]. In the absence of blood flow, the patient's [[hypocalcemia]] and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and [[metacarpophalangeal joint]]s flex, the [[distal interphalangeal joint|DIP]] and [[proximal interphalangeal joint|PIP]] joints extend, and the fingers [[adduction|adduct]]. The sign is also known as '''''main d'accoucheur''''' ([[French language|French]] for "''hand of the [[obstetrician]]''") because it supposedly resembles the position of an obstetrician's hand in delivering a baby.<ref>{{cite journal |title=Main d'accoucheur - Oxford Reference |url=https://www.oxfordreference.com/view/10.1093/oi/authority.20110803100127204 |website=www.oxfordreference.com |doi= |language=en }}</ref> |
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==History== |
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The sign is named after French physician [[Armand Trousseau]] who described the phenomenon in 1861.<ref>Trousseau a. ''Clinique médicale de l'Hôtel-Dieu de Paris.'' Paris, 1861. Volume 2: 112-114.</ref> It is distinct from the [[Trousseau sign of malignancy]] |
The sign is named after French physician [[Armand Trousseau]], who described the phenomenon in 1861.<ref>Trousseau a. ''Clinique médicale de l'Hôtel-Dieu de Paris.'' Paris, 1861. Volume 2: 112-114.</ref> It is distinct from the [[Trousseau sign of malignancy]], which is a type of abnormal blood clot due to certain types of cancer.<ref>[http://www.gpnotebook.co.uk/simplepage.cfm?ID=-1556807643 Trousseau's sign of visceral malignancy] in [[GPnotebook]], retrieved May 2022</ref> |
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==References== |
==References== |
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{{Electrolyte abnormalities}} |
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{{Eponymous medical signs for endocrinology}} |
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[[Category:Symptoms and signs: Endocrinology, nutrition, and metabolism]] |
[[Category:Symptoms and signs: Endocrinology, nutrition, and metabolism]] |
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{{med-sign-stub}} |
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Latest revision as of 22:59, 30 May 2024
| Trousseau sign of latent tetany | |
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| The flexed wrist and metacarpophalangeal joint, and the extended distal and proximal interphalangeal joint are characteristic of Trousseau sign of latent tetany. | |
| Differential diagnosis | low calcium |
Trousseau sign of latent tetany is a medical sign observed in patients with low calcium.[1] From 1 to 4 percent of normal patients will test positive for Trousseau's sign of latent tetany.[2] This sign may be positive before other manifestations of hypocalcemia such as hyperreflexia and tetany, as such it is generally believed to be more sensitive (94%) than the Chvostek sign (29%) for hypocalcemia.[3][4] This sign may also be observed as a symptom of hyperventilation syndrome as a result of hypocapnia-induced reduction of calcium levels in the blood.[5]
To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery. In the absence of blood flow, the patient's hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joints flex, the DIP and PIP joints extend, and the fingers adduct. The sign is also known as main d'accoucheur (French for "hand of the obstetrician") because it supposedly resembles the position of an obstetrician's hand in delivering a baby.[6]
History
[edit]The sign is named after French physician Armand Trousseau, who described the phenomenon in 1861.[7] It is distinct from the Trousseau sign of malignancy, which is a type of abnormal blood clot due to certain types of cancer.[8]
References
[edit]- ^ Kumar, Abbas, Fausto. Pathologic Basis of Disease, 7th edition. Philadelphia: Elsevier-Saunders, 2005. 1188.
- ^ Dennis, Mark; Bowen, William Talbot; Cho, Lucy (2012). "Trousseau's sign". Mechanisms of Clinical Signs. Elsevier. p. 555. ISBN 978-0729540759; pbk
{{cite book}}: CS1 maint: postscript (link) - ^ Fonseca, OA; Calverley, JR (August 1967). "Neurological manifestations of hypoparathyroidism". Archives of Internal Medicine. 120 (2): 202–6. doi:10.1001/archinte.1967.00300020074009. PMID 4952674.
- ^ Schaat M, Payne CA. Effect of diphenylhydantoin and phenobarbital on latent tetany
- ^ "Hyperventilation Syndrome Clinical Presentation: History, Physical Examination". emedicine.medscape.com. Retrieved 2024-05-24.
- ^ "Main d'accoucheur - Oxford Reference". www.oxfordreference.com.
- ^ Trousseau a. Clinique médicale de l'Hôtel-Dieu de Paris. Paris, 1861. Volume 2: 112-114.
- ^ Trousseau's sign of visceral malignancy in GPnotebook, retrieved May 2022
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