PANCE Pulmonology Practice Test

Which statement about Homan's sign for DVT is most accurate?

It is a highly reliable sign for DVT It is unreliable for DVT assessment It confirms DVT when positive It differentiates DVT from cellulitis

Correct Answer:

It is unreliable for DVT assessment

Explanation:

Homan's sign is not a reliable indicator for DVT. The test—holding the foot in dorsiflexion to elicit calf pain—has very limited sensitivity and specificity, so a positive or negative result does not meaningfully change the probability of DVT. Calf pain can arise from many other causes (muscle strain, cellulitis, irritation of the Achilles or soleus area, etc.), and some patients with DVT may not have this sign at all. Because of this poor diagnostic value, a positive Homan sign does not confirm DVT, and a negative sign does not rule it out. In practice, diagnosis relies on imaging with compression ultrasonography (and, in low-risk patients, D-dimer to help triage), rather than on Homan's sign.

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