Trousseau's Sign

Original Editor - Arnold Fredrick D'Souza Top Contributors - Arnold Fredrick D'Souza

Introduction

This sign is named after Dr. Armand Trousseau, a French internist, who is credited with its discovery in 1861. Its presence is suggestive of hypocalcemia.[1]

Technique

Place the sphygmomanometer cuff around the arm as you would for measuring blood pressure. Slowly inflate the cuff up to 20 mmHg and wait for 2 - 3 minutes. Observe the hand for any posturing.[2][3]

[4]

Interpretation

A positive sign is characterized by the appearance of a carpopedal spasm which involves flexion of the wrist, thumb, and MCP joints along with hyperextension of the IP joints. This spasm results from the ischemia that is induced by compression through the inflated cuff.[2]

Under 4 percent of healthy individuals may present with a positive Trousseau's sign.[2][3]

Clinical significance

Evaluation and identification of the Trousseau's sign during routine measurement of vital signs will allow therapists to immediately notify the physician regarding the possibility of hypocalcemia, thereby enabling rapid correction of the same.[2]

References

  1. Trousseau a. Clinique médicale de l'Hôtel-Dieu de Paris. Paris, 1861. Volume 2: 112-114.
  2. 2.0 2.1 2.2 2.3 Patel M, Hu EW. Trousseau Sign. [Updated 2020 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557832/
  3. 3.0 3.1 Rehman HU, Wunder S. Trousseau sign in hypocalcemia. CMAJ. 2011 May 17;183(8):E498. doi: 10.1503/cmaj.100613. Epub 2011 Feb 28. PMID: 21398222; PMCID: PMC3091937
  4. Dr. Vivek Dudeja ENT SPECIALIST. Trousseau's sign of latent tetany seen in hypocalcemia. 2017. [online] Available at: <https://www.youtube.com/watch?v=e03EKe9peUo> [Accessed 21 August 2020].