Hildreth's sign

Hildreth's sign is a physical examination technique useful in differentiating glomus tumors and hemangiopericytomas from other masses with a similar appearance. It was first described by DH Hildreth, in 1970.[1]

Hildreth's sign
Differential diagnosisglomus tumors and hemangiopericytomas

Technique

After assessing the mass for pain or tenderness, the patient is asked to elevate the affected limb and slowly inflate the cuff of a sphygmomanometer around it, while the examiner massages the limb to exsanguinate it. Hildreth's sign is positive if the patient notes relief of the pain or tenderness while the cuff is inflated, and experiences sudden onset of pain in the mass when the pressure in the cuff is released.

Value in diagnosis

One study reports the test has a sensitivity of 92%, a specificity of 91%, a positive predictive value of 92% and a negative predictive value of 91% in diagnosing glomus tumors.[2]

References
  1. Hildreth DH (1970). "The ischemia test for glomus tumor: a new diagnostic test". Rev Surg. 27 (2): 147–8. PMID 4315716.
  2. GIELE, H (1 April 2002). "Hildreth's Test is a Reliable Clinical Sign for the Diagnosis of Glomus Tumours". The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand. 27 (2): 157–158. doi:10.1054/jhsb.2001.0724. PMID 12027491. S2CID 29745831.
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