Exam

Hoffman Sign

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Hoffman Sign, Hoffman Reflex, Hoffman's Reflex

  • Technique
  1. Patient pronates hand with fingers extended and relaxed
  2. Examiner holds the patient's pronated hand, and supports the middle finger below the DIP joint
  3. Examiner quickly presses or flicks down on the Fingernail region of the middle finger
  • Findings
  • Abnormal (Positive Hoffman Sign)
  1. Involuntary flexion and adduction (opposition) of the thumb
  2. Other fingers may also flex (e.g. index finger)
  • Causes
  • Abnormal Reflex
  1. Normal finding in 3% of U.S. population (typically present bilaterally in these patients)
  2. Upper Motor Neuron Lesion (Corticospinal tract)
  • References
  1. Degowin and Degowin (1987) Bedside Diagnostic Exam, Macmillan Publishing, New York, p. 820