Hoover's Sign: Causes & Reasons

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Possible Causes for Hoover's Sign

Chronic Obstructive Pulmonary Disease

Signs of advanced disease include pursed-lip breathing, accessory respiratory muscle use, paradoxical inward movement of the lower rib cage during inspiration (Hoover sign [merckmanuals.com]

Respiratory Muscle Paralysis

A 34-year-old lady presented with generalised weakness of body, indistinguishable from myasthenia gravis within 24 hours of a wasp sting. Respiratory muscle paralysis leading to respiratory failure developed and mechanical ventilatory support was required. The patient made an uneventful recovery. [ncbi.nlm.nih.gov]

Conversion Disorder

Upon examination, the patient displayed obvious left-sided Hoover sign as well as a hip abductor sign (ie, weakness of hip abduction in the affected limb, which returned to [empr.com]

sign). [merckmanuals.com]

In a supine patient, the examiner's hand under the heel of a "paralyzed" leg detects downward pressure when the patient lifts the unaffected leg against resistance (Hoover [merckmanuals.com]

Basilar Skull Fracture

[…] dorsalis Gowers' sign Hoover's sign Lasègue's sign Trendelenburg's sign Torso Beevor's sign General Todd's paresis Jolly's test v t e General wounds and injuries (T08-T35 [en.wikipedia.org]

Westphal's sign Upper limb Hoffmann's sign Other torso/limbs Upper limb Froment's sign carpal tunnel syndrome Tinel sign Phalen maneuver Lower limb Abadie's sign of tabes [en.wikipedia.org]

Cushing's triad Miller Fisher test PNS Reflexes of extremities/ corticospinal tract Combination Jendrassik maneuver Lower limb Babinski sign Chaddock reflex Oppenheim's sign [en.wikipedia.org]

Extrapulmonary Alveolar Hypoventilation

sign, suprasternal and supraclavicular retractions, tachypnea (RR > 30 bpm), paradoxical breathing], central cyanosis (including lips and tongue), sweating, tachycardia, [xlung.net]

[…] more findings: altered state of consciousness (from agitation to lethargy), increased work of breathing [nasal flaring, use of accessory muscles, intercostal retraction, Hoover [xlung.net]

Psychogenic Movement Disorders

Another possibility is showing the patient with functional motor symptoms their physical signs (e.g., Hoover sign); if done in the right way, this could be one of the most [frontiersin.org]

Positive features of functional weakness on examination include Hoover’s sign, when there is weakness of hip extension which normalises with contralateral hip flexion, and [en.wikipedia.org]

View/Print Table TABLE 4 Clinical Clues to Pseudoneurologic Syndromes Syndrome Clues Pseudoparalysis Drop test Hoover test Adductor sign Pseudosensory syndromes Tuning fork [aafp.org]

Auricular Hematoma

Westphal's sign Upper limb Hoffmann's sign Other torso/limbs Upper limb Froment's sign carpal tunnel syndrome Tinel sign Phalen maneuver Lower limb Abadie's sign of tabes [en.wikipedia.org]

Cushing's triad Miller Fisher test PNS Reflexes of extremities/ corticospinal tract Combination Jendrassik maneuver Lower limb Babinski sign Chaddock reflex Oppenheim's sign [en.wikipedia.org]

Todd Paralysis

Hoover’s sign was suggestive of non-organic paresis of left leg. Normal reflexes and muscle tone was present and plantar reflex was flexor. [ispub.com]

There was no voluntary movement of the left arm or leg but she held her arm briefly when a pronator drift sign was attempted before letting go. [ispub.com]

Obstructive Atelectasis

sign フーバー徴候 hospital acquired (nosocomial) infection院内感染 humidification加湿 humidifier加湿器 husky voice嗄（さ）声 hydrostatic pressure静水圧 hyperbaric高圧の hyperpnea過呼吸 hypersensitivity [tokyo-med.ac.jp]

[…] gas (gaseous) exchangeガス交換 h hair line毛髪線〈胸部 X線上の葉間線〉 hemoptysis喀血 hemorrhagic出血性 hemosputum血痰 hemothorax血胸 hilar肺門の hoarse voice嗄（さ）声 hoarseness嗄（さ）声 honeycomb lung蜂巣肺 Hoover's [tokyo-med.ac.jp]

Idiopathic Mediastinal Fibrosis

Acute Subglottic Laryngitis

sign. [1] [11] Drooling or a very sick appearance indicate other medical conditions, such as epiglottitis. [11] Causes [ edit ] Croup is usually deemed to be due to a viral [en.wikipedia.org]

[…] croup worsens, stridor may decrease considerably. [1] Other symptoms include fever, coryza (symptoms typical of the common cold ), and indrawing of the chest wall –known as Hoover's [en.wikipedia.org]

Factitious Disorder

[…] the Hoover's sign for the diagnosis of conversion disorder. [ncbi.nlm.nih.gov]

The first challenge is to detect them, and recent studies have confirmed the importance of "positive" clinical bedside signs based on incoherence and discordance, such as [ncbi.nlm.nih.gov]

Paraparesis

Chapter 23 presents a case of functional paraparesis, and discusses signs of functional weakness, including Hoover’s sign, give-way weakness, inconsistency of findings, and [oxfordmedicine.com]

Cauda Equina Syndrome

Abstract In the first prospective comparison of 'scan-negative' (n=11) and 'scan-positive' (n=7) patients with cauda equina syndrome (CES) we found that Hoover's sign of functional [ncbi.nlm.nih.gov]

Tracheobronchomegaly

Croup

sign.[1][11] Drooling or a very sick appearance indicate other medical conditions, such as epiglottitis.[11] Causes[edit] Croup is usually deemed to be due to a viral infection [en.wikipedia.org]

[…] croup worsens, stridor may decrease considerably.[1] Other symptoms include fever, coryza (symptoms typical of the common cold), and indrawing of the chest wall–known as Hoover's [en.wikipedia.org]

Spasmodic Croup

sign. [en.wikipedia.org]

As croup worsens, stridor may decrease considerably.Other symptoms include fever, coryza (symptoms typical of the common cold), and indrawing of the chest wall–known as Hoover's [en.wikipedia.org]

Panacinar Emphysema

Some patients with advanced chronic obstructive pulmonary disease have paradoxical inward movement of the lower rib cage (Hoover sign) due to diaphragmatic contraction in [intechopen.com]

Bronchiolitis

sign) bluish skin The term usually refers to acute viral bronchiolitis, a common disease in infancy. [en.wikipedia.org]

sign ) bluish skin Causes Edit Acute inflammatory exudate occluding the lumen of the bronchiole and acute inflammation of part of the wall of the bronchiole The term usually [en.m.wikipedia.org]

24 hours) significantly decreased activity history of stopping breathing respiratory rate >70/min presence of nasal flaring and/or grunting severe chest wall recession (Hoover's [en.wikipedia.org]

Respiratory Bronchiolitis Interstitial Lung Disease

Idiopathic Bronchiectasis

Acute Bronchitis

Signs of advanced disease include pursed-lip breathing, accessory respiratory muscle use, paradoxical inward movement of the lower rib cage during inspiration (Hoover sign [msdmanuals.com]

Bronchitis

Signs of advanced disease include pursed-lip breathing, accessory respiratory muscle use, paradoxical inward movement of the lower rib cage during inspiration (Hoover sign [msdmanuals.com]

Acute Respiratory Failure

sign, suprasternal and supraclavicular retractions, tachypnea (RR > 30 bpm), paradoxical breathing], central cyanosis (including lips and tongue), sweating, tachycardia, [xlung.net]

[…] more findings: altered state of consciousness (from agitation to lethargy), increased work of breathing [nasal flaring, use of accessory muscles, intercostal retraction, Hoover [xlung.net]

Pituitary Cushing Syndrome

[…] dorsalis Gowers' sign Hoover's sign Lasègue's sign Trendelenburg's sign Torso Beevor's sign General Todd's paresis Jolly's test v t e Eponymous medical signs for muscles [en.wikipedia.org]

Westphal's sign Upper limb Hoffmann's sign Other torso/limbs Upper limb Froment's sign carpal tunnel syndrome Tinel sign Phalen maneuver Lower limb Abadie's sign of tabes [en.wikipedia.org]

Cushing's triad Miller Fisher test PNS Reflexes of extremities/ corticospinal tract Combination Jendrassik maneuver Lower limb Babinski sign Chaddock reflex Oppenheim's sign [en.wikipedia.org]

Familial Congenital Nasolacrimal Duct Obstruction

Obstructive respiratory disease ininfants can result in the Hoover sign,or paradoxical (seesaw), breathing. [quizlet.com]

Bronchial Disease

sign) Cyanosis Elevated jugular venous pulse (JVP) Peripheral edema Thoracic examination reveals the following: Hyperinflation (barrel chest) Wheezing – Frequently heard [emedicine.medscape.com]

[…] include the following: Tachypnea and respiratory distress with simple activities Use of accessory respiratory muscles and paradoxical indrawing of lower intercostal spaces (Hoover [emedicine.medscape.com]

Neurological Disorder

’s sign Sensitivity 94%, specificity 99% (32) Present Hoover’s test: the expected response is that the normal limb heel pushes down against the examiner’s hand as the patient [ajp.psychiatryonline.org]

Some examples of these signs are: • Hoover’s test is for of functional leg weakness – the patient may have difficulty pushing their “bad” leg down (hip extension), but when [rarediseases.org]

[…] tries to raise the weak leg’s hip Positive Hoover’s sign: if the examiner does not feel the “normal” leg’s heel pushing down as the patient flexes the hip of the “weak” limb [ajp.psychiatryonline.org]

Pancreatic Insufficiency - Anemia - Hyperostosis

sign 4373005 Clubbing of nail 4374004 TV - Congenital tricuspid valve abnormality 4381006 Verbal paraphasia 4386001 Bronchospasm 4390004 Chronic lithium nephrotoxicity 4397001 [build.fhir.org]

[…] sites of metacarpus 4354006 Open dislocation of scapula 4356008 Gingival soft tissue recession 4359001 Early congenital syphilis 4364002 Structure of associations 4367009 Hoover [build.fhir.org]

X-Linked Parkinsonism with Spasticity

Finally, there may be other clinical features of functional neurological disorders, such as “give-way” weakness, a positive Hoover’s sign, or non-anatomical sensory loss [ncbi.nlm.nih.gov]