Homans Sign for Deep Vein Thrombosis
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- เผยแพร่เมื่อ 29 มิ.ย. 2024
- It is a MUST to understand how to perform the Homans Sign for deep vein thrombosis when working with patients. Identifying a DVT is more than just squeezing the calf. Look for redness, warmth, swelling and pain.
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#HomansSign#DVT#OrthoEvalPal
Me: Looking up why my leg hurts
Also me: Finding this video and getting scared
Great quick and simple practical explanation of your techniques.
As a nurse preparing for a grad program I highly appreciate your explanation for your assessment method, where Google was not able to do the trick for me.
I had back surgery (laminectomy) in May 2021. They gave me your test twice a day every day I was there for a week. Within hours of being discharged I was in an ambulance being rushed to the hospital with pulmonary embolisms. Ultrasound showed DVTs in both legs and CT scan showed multiple PEs in both lungs, There was a big investigation into it by both the state board of health and the hospital as to how this could happen. One nurse said in all her years I was the first patient with multiple DVTs with no symptoms.
"DVTs with no symptoms"
no swelling or redness in your legs?
@@victorcotu No swelling, no redness, no discomfort. Yet the ultrasound showed extensive DVT's in both legs. Nurse said she had never seen anything like it before. Of course the pulmonary embolisms were indeed painful. I almost passed out. When the EMTs gave me oxygen it helped a great deal.
Thank you for your comment (on your experience) I've often wondered if that is/was a possibility.
Just proves my point once again: doctors don't know everything and DO make mistakes.
Best explanation and exhibit of Home s sign.
Thank u for ur best explanation sir .... continue this with many patients experimentally sir.. thank u so much
Very helpful. Thanks for making such a clear and easy to follow video.
You're very welcome!
This actually reassured me a bit. I’ve been having pain in my calf, when I flex my own foot up towards me, and it made me think I had a blood clot. But knowing it could be due to tightness makes me feel reassured that I probably don’t have it. I have no swelling, no redness, or a warm feeling. I just have achy feelings in my legs.
You should seek medical attention for this. Could be an easy fix.
I did. I got a D-Dimer test done. No clots. They think it’s muscle related.
Oh my god same here....I was panicking.
Exactly
Thanks for sharing
Same thing happened to me to top it happened a week after covid vaccine shot
So I will get it checked anyways
Great video. Thanks for the explanation!
Thank you. Very informative explanation.
Have pain in my thigh and my middle toes were numb for a bit. Had this about a month ago. Calf not warm and flexing ankle doesn’t make it hurt worse. Do stand a lot but moving back and forth while working.
THANK YOU SIR FOR SHARING HOMANS SIGN
You are welcome!
Highly informative..thanks
Great man. Write a book with dvd and I will buy it immediatly....great.
Thank you Vasileios! Please share. Hoping to do some webinars related to piecing all of these videos together.
To the point, amazing 👍
Great video! Thanks for sharing Paul Marquis PT
Thank you very much!
What a great dr I wish you were local for me. Thanks for the video.🙂
You are welcome!
I appreciate this information, thank you
Glad it was helpful! Thanks Edna!
Thank you much. Im in nursing school and would like to see how to check for DVT. Very informative and easy to understand
Great! Check this one out. A patient with a DVT
Thank you will do if need to
Great vid!
Thanks Reda!
Was very helpful
You are great sir Thinking you from Saudi Arabia
Thank you Aziz!
I was taught the Homans Test and all the s/s you mentioned but I wasn’t told to squeeze the calf. That seems very important. Thank you for your video. I will be testing with your technique from now on.
Glad to hear it!
Yes agreed . in all my 27 years of nursing . never was told to squeeze the calf....
Squeezing calf is diffrent thing. Thats why you werent taught about this.
@@pamanderson5168 Squeezing the calf (as well as massages) could make the blood clot to dislodge.
@@victorcotu Agree 100% What he did was within his scope of practice as MD. Nurses are not trained to squeeze, unless you are a Family nurse practitioner with proper training/practice license. Same thing in abdominal exam, ward nurses are not allowed to palpate, if not at all any deeper than what MDs are trained for. There's a difference in the scope of practice.
Sorry my husband had only calf pain no other symptoms no swelling, no redness no heat! Nearly died from a PE if you have any pain in your calf have a Doppler. Also if you ever have a blood clot, get generic testing! My husband ended up having Factor V Leiden. They blamed the clot on a trip we had but we were very active so I didn’t buy it! I pushed for genetic testing and sure enough he has a clotting disorder. All of our kids were then tested too! Clotting disorders are often missed and under diagnosis’s and have tragic outcomes. Better safe then sorry
Thank you, Carol McHale 👍🏼
I agree for another reason too .. such as clot in frontal shin area rather than calf pain. My sympathy to you for you sudden loss & thank you for sharing accurate details.
🙏
Same happened to me. Same genetic disorder discovered
You are right. Sometimes the ache in the calf is all there is and that can mean a DVT. Ask me how I know.
I have been fortunate to have survived a DVT in both of my legs. Best wishes!
Thanks x) we studied it in the supine position and i thought it wasn't the best because of probable sciatica , keep up x)
Thanks! Lots more to come. Please share.
Great video it helped me out a lot and answered questions I had about my calf muscles hurting
Glad it helped!
What happened to your calf .
Hi, thanks.
I was unable to leave a thumbs up from watching the youtube video via Safari, so I rewatched having opened TH-cam directly on my phone.
That has allowed me to leave a big Thumbs Up.
Thanks for your video.
Let Safari know something is inhibiting your video.
👍🏼
My symptoms have been pain in the lower leg which started this last week during the
night only. Pain now moving up to near the hip, again during the night only. No redness visible. Left leg only.
My shins have been painful for decades.
H 1.83m, W 73.5kg, 62yrs male, non smoker.
Not a bad idea to have a dvt ruled out. Then I would see an orthopedic specialist
Great Video.
Pls do a video on Assessment of SCI, Thank you.
Thanks Sabir! I do not see SCI patients. I specialize In sports and orthopedics. Sorry!
I pray for healing from all blood issues in Jesus name amen 🙏
I don't have redness or warmth, but I do have bruising that showed up a few days after the swelling in my leg started to go down. It mostly looks like yellowish and greenish old bruising as if it's old blood that took a while to reach the surface of my skin where I can see it. My calf isn't hurting as much as it was when flexing, stretching and squeezing the muscle, but it's aching when sitting or laying down at night, even though it doesn't hurt in my calf to exercise or walk around. I did also recently develop pain and swelling inside my knee joint while running, but that happened after the other symptoms (calf pain and swelling of my leg) had started. Also, think calf pain started as a result of a compression sleeve I was wearing while running for knee support. I think it was too tight and was causing poor circulation while exercising. I stopped wearing it when the swelling started. The swelling finally went down after several days, but now the other symptoms have been persisting for over a week. The thought of a blood clot had not even occurred to me until I talked to my sister and she was concerned, because she has had a PE after leg surgery to remove dysfunctional veins a few years ago.
Just remember also that not having redness and swelling isn't a guarantee that you don't have a clot as I went and was told muscle pain, next day took myself to walk in centre at my local hospital and had D dimer test which was positive, now on apixaban while I wait for my ultrasound Wednesday.
I'm not wanting to scare anyone just be mindful that you don't always have classic symptoms.
Stay safe and well 🙏
9
Very very informative. I‘ve been worried my spontaneously sore calf was a clot, but no redness, warmth, or discomfort from this test... What a relief! Still, I’ll leave it to my doctor to decide. I’ll be seeing them this coming month, would ordering a blood test be a safe way to ensure it’s not a clot?
Hi Markus, yes, that's what they usually do. If the test is positive, then you go to a doppler ultrasound. Best of luck!!
What was your outcome?
What was your outcome.
Thank you I have been have Nocturnal calf muscle pain..as in pulling my calf muscle...That is extremely painful it wakes me right out of a sound sleep...I can relate it to when I was pregnant years ago.....So far I have had three incidents of this....I have chronic migraines and have late stage Lyme disease..so I do tend to rest for long lengths of time when experiencing a migraine...I have not traveled.....I treated this with heat, then ice then toe point stretches to the ceiling...Because after the calf muscle pull I was unable to walk properly with my foot 🦶🏻 flat on the floor...I could only tip toe.which after two days of walking in that manner my shin began to ache....
I performed your test... I’m not sure of a blood clot...However my leg is very warm to touch compared to other leg..
Not common to have a blood clot that just happens at night. If you are worried though, you should see your medical provider
@@OrthoEvalPal ok...Thank you
What happened 🙄
This video is very helpful, but my husband’s dvt didn’t match these indicators. His PCP ordered a blood test which indicated that there were blood clots present. The Doppler Ultrasound confirmed the presence of blot clots.
Have a pinching pain in front of my leg around same level near bottom of my calf. Redness and warmth no swelling that I can see and no pain in the back of my calf.
I am high risk, But I have been working to change this by losing weight.
thank you , understandable
You are welcome!
I am pregnant, and I have swollen calf, doctor did the blood tests and they did ultrasound of my leg two times, they did not find any clot there, but I am still concern because my swollen calf is not settling down like before, I don't have any pain there, but sometimes I feel heaviness in my leg, can you please let me know is it alright
Dr often on my waking up from sleep my muscle on back of my leg stiffened / pain where I couldn't fold it ,, I have to let it stay in that position for minutes and relax it self !!
Thanks for the video. Can you get a DVT on the side of the calf, or only in the back of the calf?
Hi think I might have it
How to confirm DVT with pitting oedema or bowman ' s test ? Which one is better
Do various versions cause it
A better question is where do you get this tested obviously not the ER but no one talks about how people get to a doctor I genuinely don’t know.
Hi Doctor , so I am having pain cramp feeling going all over my leg it hurts when I walk I wake up at night in a lot of pain I don’t have redness I haven’t noticed , swelling . I do have herniated disc since 2019 due to a car accident in which I was impacted that caused meniscus tear I was getting therapy for it but I never finished so now I have herniated disc on my neck/ spine and meniscus tear untreated . Could this be the Cause of my leg cramping ? and what can I do to prevent it .
Girl and leg are very beautiful ❤️❤️
I have pain but it’s more in my upper thigh in front , can clot occur in that area? Thank you
I have pain in my calf up to my upper thigh of my left leg. No swelling nor any redness. I am hoping to see a doctor soon but I can't at the moment. I have no insurance and no money to afford it. Its been happening for a month now. I did the test and I don't have a deep pain in the center of my calf, just on the sides. I am pretty active, but I do vape (quitting soon). Any thoughts on this?
thank you for the very professional video. I have a question about DVT. I just had hip replacement R hip, 2 days ago, and my thigh is swollen and tight. Not much bruising or discoloration. The calf seems unaffected, no edema or swelling , no change.. I think my thigh is tight due to soft tissue trauma ( I have thick leg muscles)...but should I worry?
Hi Dave, that is not uncommon at all. Should resolve and settle down over the next week or so.
I've had DVT symptoms twice now. Both times were directly after long car rides. Both times, I had negative ultrasounds. I'm going back for a follow-up from my last ultrasound today. I have mild swelling, redness and a feeling of pressure/pain that improves dramatically, when I take aspirin and my preworkout drink. I have Ankylosing Spondylitis and have been on biologics for 20 years. Is there a chance an ultrasound can mis a DVT? Is there a such thing as a mild case of DVT?
Calf pain on squeezing calf muscle is MOSE's sign.
HOMAN's sign is resistance to dorsiflexion of foot.
Whats for contraindications?
Doc, after a fall my bike crash it in my calf and got a huge swelling in my front calf. Its almost like a cramp pain nonstop. Im afraid that a huge trauma like that increases the chances of blod clot right?
I have a question? I have had some swelling in my left leg mostly my ankle and foot, but I have a very Sharp pain in my upper thigh and it's very warm to the touch with some sharpness and numbness. Any ideas?
i have a very visible vein on the top of my foot and when tired the veins get mad and also become visible in my legs. please answer sorry for the bad english thanks.
Can u get a dvt from sleeping/laying in bed for 12-15 hours straight? I have factor 5 liden and history of clots especially during pregnancy. I wanna know if I should be worried while having flu or covid (not sure) and spending most of several days in a row just laying/sleeping in bed...?
A few weeks ago, I climbed some stairs and as I reached the last step, my calf just wouldn't or couldn't take it anymore. Since then, I've had a painful calf, especially after a long day. It's not the whole length of the calf, more like only a spot. I don't have anyone to help me with this test, I don't think it's warmer than the other leg, not swollen that I can see. Should I be concerned? Our doctors are VERY expensive and forking out food money to be told it's just sprained, will give me a heart attach 🤣
I have all the symptons of dvt, all the swelling, lumpy vein in my thighs, been a week, only just realised it may be this, will go hosp
Yes, you should. Good luck!
@@OrthoEvalPal hi, its dvt. Been given blood thinners, they say its caused by gout, had gout over 4 years nw, is there anything else to aid better blood flow and reduce swelling?
@@mohammednozir5786 I actual am doing a video about just that in the next couple days
@@OrthoEvalPal thank you very much, will keep an eye out.
@@mohammednozir5786 what happened 🙄
how can i tell if i have a dvt or a muscle strain
I have the same pain but it's not swollen
Hmm the homans test actually makes my pain go away.
Probably not a blood clot then
Do DVT pain go away or it's consistent?
Is there a test for thigh clot
I have pain in my thigh, knee and shin, my calf hurts slightly feels like it's pulling when I walk but there is no swelling, redness, warmth or discolouration can that be a sign of dvt
Hi,.
I was on a flight for 19 hours.ended up after the flight my ankles swollen and difficult to walk for three days is this DVT? I
I kept walking in the flight but ended up swollen and walking problem
I am a nursing student and I learned that we are not to palpate or squeeze the calf if we suspect a DVT so that the clot does not come loose and cause a PE. Is this something we should worry about when looking for the Homan's sign?
Hi Victoria, I never palpate deep and I never massage or foam roll when I suspect a DVT. A person walking and contracting their calf will put more pressure on it then a light squeeze. Good question. Best, Paul
The book says to dorsiflex the ankle and also squeeze the back of the leg to see if that produces any pain. But if the patient does have a DVT, squeezing may lead to embolism.
What if I am experiencing calf spasms or cramps in my calf’s and I have no obvious swelling or redness or warmth but the pain is there, it comes and goes and when it comes it is very painful, but it goes away as my day goes on
I'm having that too...exactly how you explain it.
Very helpful. I've been struggling to sleep for 2 months due to calf pain, which is now radiating into my foot and causing numbness. I haven't had an injury or actual muscle pain as such but its causing real discomfort when I'm not moving. No redness, heat or swelling so I'm hoping it isn't a serious issue
Any update?
@@asteven5308 yeah...dead
What happened 🙄
any update? you alright?
Sciatica ??
Complications of dvt?
hi ....that was a good one..thank you...i have one question....is it possible for DVT to occur simultaneously on both legs? or else...if similar symptoms appear on both legs, could it be indicating something else?
Great question Prince! It can happen on both legs but very unlikely. Could be neuropathy, lumbar spinal stenosis, compartment syndrome and several other things.
One side is classic DVt
Can I give a mild exercise movement after diagnosed dvt patient?
no
its it possible to have one is both legs or one in the arms and neck? Ive had off and on pain in both my calves then my arms and neck since July the pain was first in my calves, then in August or September my shoulder hurt and I popped it which immediatly made me have neck pain in the center of the right side.
Not likely you had DVT's in your neck or arms. I would be looking for other causes.
I have a brother who's 61 years old , He was having constant back pain and then hip pain off and on , (could be back issues but he feels it in his hip ) . He lost his job of 23 years and the insurance was cancelled . I got him signed up for new health insurance , but it wont be activated for a couple of weeks . He was in so much pain with his back he has not been able to work , so no income at all . He is taking Nuerontin and Tramadol for pain but they don't help with this new issue . It got worse to the point where he was in bed a lot . He refuses to go to the hospital , because of no insurance . I looked at His legs and one ( Right ) is more reddish pink while the other is normal . It is also swollen and warmer than the other . The leg feels tight in the calf area , and is bigger than the other , even in his thigh area . He has bad pain when I try to move that leg at all . So far I can get him to at least get out of bed several times a day to watch movies instead of laying down all the time . I also started getting him to take 1/2 an aspirin 2 times a day since I read they will put him on blood thinners to correct this . I don't know if the aspirin is a waste of time or can it help ? He knows the Doc will tell Him to go to the E.R. , which he will not do yet . I am worried that having to wait a couple of weeks is too risky but he wont budge without insurance . He does not qualify for medicare , so I don't know what else to do ? What can I do to help him with this ? heat or ice ? do either help ?
This is so sad. He needs the hospital. Aspirin will not do anything. I'm sorry you guys are in such a pickle
@@EMKAT261 Aspirin DID help , and I finally got him into the ER , He did have a blood clot , and also they said he had a large abdominal aorta aneurysm , and a mass on his kidney . The insurance was a scam , and in the end they paid for nothing ! The mass on the kidney turned out to be a really bad infection . The idiot kidney doctor wanted to wait a month to see what developed ??? He had a lump the size of your fist sticking out of his back , but he did not take that serious . We went to the ER again and they said he was full of pus , so they put a drain in his back , at the lump . I got 55 ounces of pus out of him the first night . The infectious disease doc said if we waited the month like the kidney doc wanted to , my bro would be dead . He is doing okay now , had the aneurysm repaired , and the infection is gone now . He came close to dying , and it sucks that a trained medical doctor would have let that happen , if we listened to him .
You look like Dr. Strange!
But what about when the thrombosis is behind the knee or above the knee or in the thigh or groin?
Could there be thrombosis is the groin?
Hey Doc,
I have an issue in my Thigh but there is no redness but my major problem is that I feel some kind of liquid in my thigh.
what is this and is this any symptoms of DVT?
I doubt you'll see this now but I started mma and spared my coach 3 times in one week and that last time he landed kicks my left leg on the upper left side of my calf below the knee. Since then I've had sharp pain in my calf when there's too much pressure on my left foot or when I rotate it outward and inward, I don't have swelling anymore and it isn't red but I was wondering if my situation could result in a dvt ?
It could but not likely. Could be some soft tissue injury. You should have it looked at by your pcp
@@OrthoEvalPal thank you I really appreciate you getting back to me. I've been extremely anxious since I found out dvts were even a thing ! I will check with my pcp asap
What if there's no redness, no hot feeling on the leg, and just a muscle soreness? What would it be?
Could be a number of other issues. Need to have it checked by a medical provider
I have pain every once in awhile right behind the knee so would I use the same technique to see if I have a dvt right behind the knee I was just at a music festival so It could’ve be a muscular thing
No not really. But, if you have any inkling that you have a clot, you need to rule it out.
It's contraindicated in acute DVT = risk of pulmonary embolism
I had ankle surgery six weeks ago and my calf hurts slightly when I walk and when I press on my calf 😔
Thank you so much!
Pls disntiguish between DVT in ankle and varicose veins
The DVT is deep and a single vein whereas varicose veins affect many superficial veins and tender on the surface. DVT is much more dangerous.
What about if I have a warm feeling on both my calves, it started on my one calf and now its both, its not hot when I touch it, but it feels like my legs have fever.
Not common to have a dvt in both. There are several things that can cause an altered sensation in the legs. You should see a medical provider to have it evaluated
sir, I am in pastor, i have DVT inmy right leg. please tell me what i have to do.
Go to the emergency room!
Hi... How to treat thrombotic occlusion in home.... My mom facing this issue
Pl guide
What happened 🙄
I HAVE BEEN IN THE BIRTH CONTROL PATCH FOR A WEEK AND NOW I FEEL MY LEGS HEAVY AND TINGLING.3DAYS A GO I TRAVEL FROM SAN DIEGO TO LOS ANGELES IN A BUS ITS LIKE 2 HOURS SITTING I DON'T IF MY SYMPTOMS ARE FROM THE PATCH OR TRAVELING.NEED HELP.
You need to go see a medical provider.
Interesting thing. (24m) I've been doing these at home for myself after a health scare when, during a panic attack with severe but temporary hypertension , I felt tingling in my left leg and still feel that sensation from time to time. No redness, warmth or pain. Could tingling be a symptom of DVT?
Not a common symptom
My wife complain of pain at the both lower leg and swelling after four months of C-section and the pain is still there after two weeks but the swelling has gone down a bit.
What could be the cause sir
Couldn't say without doing a full evaluation
Sir I actually wanted to ask that is it safe to massage the legs in DVT because my mom feels a little better after massaging tha calves . We haven't actually medically tested it to assure that she has dvt but the symptoms that I see in her are exactly the same. Please reply sir🙏or can it be the pain because she has a spondylitis
Massage of a leg with DVT is not recommended. If you suspect a DVT then absolutely have it checked by a medical provider.
@@OrthoEvalPal Thank you sir
How is she now
What happened 🙄
My calfs are soiling no pains but feeling tideness I'm very upset so i want to see doctor. Which doctor i need plz tell me anyone 😥
On Orthopedic specialist would be a good place to start
I am 100% sure they don’t recommend this test anymore, because the clot can dislodge and travel upwards..Wells score is likely the recommended test..
I have a pain in the front of my calf. On the bone you could say. No pain whatsoever on the back of the calf. It hurts when I'm walking, but not when I'm sitting down. There is no warm feeling. Can it be a blood clot if the pain is only in the front of the calf?
Yes. I understand this is very late, but maybe it can help someone else. I currently am being treated for a DVT. My pain is in the front basically on the bone. Kind of like what I would expect a shin splint to feel like. It also hurt badly to walk, but only had very little swelling, no warmth, and no notice left red on my leg. Went to Dr because I had a more obvious clot about 8 months ago. Just finished blood thinners about three weeks ago. Also have no clotting factors. Please, if you have even the slightest inkling, talk to a doctor. Thankfully my doctor decided to send me for an ultrasound despite not having what seemed to be the normal signs.
@@kristroyer6166 Thank you so much for your thoughtful reply. I did end up going to the doctor and thankfully there was no clot issue in my case. I hope you are doing well.
@@kristroyer6166 - my pain is the same - like right next to my fibula bone but hurts when I wake up - after lying still & is worsening . No other visible signs & no calf pain . We’re you treated with meds or can it be removed / eliminated ?
I’m going tomorrow - this has been months of pain after lying down .. not walking
@@elizabethhallowell5115 Hope things went well today. After being seen by a hematologist, it was determined that I have to be on blood thinners for the rest of my life, as well as wearing compression socks during the day. Hematologist said that I actually only ever had one clot. While on blood thinners it partially dissolved, but returned as soon as I was taken off of them. No cause for the abnormal clotting determined yet.
@@gabrielazki Thank you. Thankful you did not have a clot. I am doing fine since being back on the blood thinners and wearing compression socks.
Hello sir my dad is having swelling in their leg but he didn't have any pain and I do MRI And Doppler test as well so getting DVT IN reports
Could you please suggest the better' option what I have to do
Plz reply plz 😢😢😢😢
This has to be managed by his doctor
Is there a homans test for your arm?
No there isn't. There would be swelling, redness, pain
I have been having pain on my left thighs all the way to the back of my legs and struggling with my breathing.. could this DVT which now affected my lungs
I would see a Dr. for this. Not something to guess on.
What happened 🙄
Hi Dr. If there is swelling but no heat and there is a nickle size bump or hardness on the lateral side of the right calve..would this be a sign if clotting?
Not necessarily.
@@OrthoEvalPal Thank you
does absence of pain mean no DVT?
It's rare but I have seen it happen. Ususaly there is pain associated
goin' bananas
Take her socks off and look at the veins in the top of her feet. My veins were not visible in the leg with DVT-too puffy. After two DVTs and a PE I am paranoid and check my feet veins when I get up every morning. Even tho I am on thinners
That's a good tip to remember
อยากรู้วันเวลามากเรื่องนี้ฉันจะได้เตรียมตัวทำใจเตรียมสภาพร่างกาย
It depends if you had the vaccine ? (Covid-19) please let your Healthcare provider know right away !!! 🙏
What if the DVT is in the thigh? How do we know
The swelling and pain will be above the knee..Should get a Doppler if that happens.
@@OrthoEvalPalcan u help me