Trousseau sign of latent tetany

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]

Trousseau sign of latent tetany
Trousseau's Sign of Latent Tetany. Note the flexed wrist and metacarpophalangeal joint, and the extended distal and proximal interphalangeal joint.
Differential diagnosislow calcium

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.[5]

History

The sign is named after French physician Armand Trousseau, who described the phenomenon in 1861.[6] It is distinct from the Trousseau sign of malignancy, which is a type of abnormal blood clot due to certain types of cancer.[7]

References
  1. Kumar, Abbas, Fausto. Pathologic Basis of Disease, 7th edition. Philadelphia: Elsevier-Saunders, 2005. 1188.
  2. 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)
  3. 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.
  4. Schaat M, Payne CA. Effect of diphenylhydantoin and phenobarbital on latent tetany
  5. "Main d'accoucheur - Oxford Reference". www.oxfordreference.com.
  6. Trousseau a. Clinique médicale de l'Hôtel-Dieu de Paris. Paris, 1861. Volume 2: 112-114.
  7. Trousseau's sign of visceral malignancy in GPnotebook, retrieved May 2022
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