Document Type
Review
Publication Date
9-5-2008
Description
In the 1920's, Hoover described a sign that could be considered a marker of severe airway obstruction. While readily recognizable at the bedside, it may easily be missed on a cursory physical examination. Hoover's sign refers to the inspiratory retraction of the lower intercostal spaces that occurs with obstructive airway disease. It results from alteration in dynamics of diaphragmatic contraction due to hyperinflation, resulting in traction on the rib margins by the flattened diaphragm. The sign is reported to have a sensitivity of 58% and specificity of 86% for detection of airway obstruction. Seen in up to 70% of patients with severe obstruction, this sign is associated with a patient's body mass index, severity of dyspnea and frequency of exacerbations. Hence the presence of the Hoover's sign may provide valuable prognostic information in patients with airway obstruction, and can serve to complement other clinical or functional tests. We present a clinical and molecular review of the Hoover's sign and explain how it could be utilized in the bedside and emergent management of airway disease.
Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.
Citation Information
Johnston, Chambless; Krishnaswamy, Narayanaswamy; and Krishnaswamy, Guha. 2008. The Hoover's Sign of Pulmonary Disease: Molecular Basis and Clinical Relevance. Clinical and Molecular Allergy. Vol.6 https://doi.org/10.1186/1476-7961-6-8
Copyright Statement
© 2008 Johnston et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited