Key Surgical Signs – List of Surgical Signs:

Thyroid and Parathyroid Signs

• Marie’s sign: A fine hand tremor can be a sign of hyperthyroidism.
• Maroni sign: Redness over the thyroid area may also suggest hyperthyroidism.
• Pemberton’s sign: Facial congestion and vein distension when raising arms may indicate a retrosternal goiter.
• Berry’s sign: Absence of carotid pulse may indicate malignant thyromegaly.
• Dalrymple’s sign: Upper sclera is visible due to retraction of upper eyelid in primary thyrotoxicosis.
• Joffroy’s sign: Absence of wrinkling of the forehead when the patient looks upwards with the face inclined downwards in primary thyrotoxicosis.
• Von Graefe’s sign: The upper eyelid lags behind the eyeball as the patient is asked to look downwards in primary thyrotoxicosis.
• Boston sign: Jerking of the lagging lid in primary thyrotoxicosis.
• Griffith’s sign: Lag of the lower lids during elevation of the globe in primary thyrotoxicosis.
• Stellwag’s sign: Staring look and infrequent blinking of eyes with widening of palpebral fissure in primary thyrotoxicosis.
• Moebius sign: Inability or failure to converge the eyeballs in primary thyrotoxicosis.
• Riesman’s sign: Bruit over the closed eyes in primary thyrotoxicosis.
• Rosenbach’s sign: Tremor of the closed eyelids in primary thyrotoxicosis.
• Archibald’s sign: Shortened fourth and fifth digits can be a sign of pseudohypoparathyroidism.
• Chvostek’s sign: Facial twitching when tapping over the facial nerve can indicate low calcium levels.
• Trousseau’s sign: Hand spasms following inflation of a blood pressure cuff can indicate low calcium levels.

Vascular Signs

• Homan’s sign: Calf pain with foot flexion can suggest DVT.
• Mose’s or Bancroft’s sign: Calf tenderness on squeezing can suggest DVT.
• Lisker’s sign: Tibial tenderness can suggest DVT.
• Louvel’s sign: Venous pain induced by coughing can suggest DVT.
• Lowenberg’s sign: Assymetry in calf pressure tolerance can suggest DVT.
• Pratt’s sign: Dilated veins over the tibia can suggest DVT.
• Ramirez sign: Pain from an inflated cuff above the knee can suggest DVT.
• Crueveilhier’s sign (saphena varix): A cough impulse felt at the saphenofemoral junction while standing may indicate varicose veins.
• Buerger’s sign: A change in foot color with elevation may indicate peripheral artery disease.
• Adson’s sign: Decreased pulse with certain neck movements can indicate thoracic outlet syndrome.
• Henle-Coenen sign: Distal vessel pulsation after fistula occlusion indicates safe ligation.
• Branham’s sign: Slowing of heart rate with fistula compression can indicate an arteriovenous fistula.

Abdominal Signs

• Pointing sign: Patient precisely localizes the pain, which can suggest appendicitis.
• Rovsing’s sign: Right lower quadrant pain with left-sided pressure can suggest appendicitis.
• Dunphy’s sign: Increased pain with coughing can suggest appendicitis.
• Aaron sign: Pain in the epigastrium or chest with pressure on McBurney’s point can suggest appendicitis.
• Ten Horn sign: Pain with gentle traction of the right testicle can suggest appendicitis.
• Cope’s psoas sign: Pelvic pain upon extension of the right thigh can suggest retrocecal appendicitis.
• Cope’s obturator sign: Pelvic pain upon internal rotation of the right thigh can suggest pelvic appendicitis.
• Bassler sign: Sharp pain when compressing the appendix can suggest chronic appendicitis.
• Adler sign: Medial shift of tenderness upon left lateral repositioning can indicate gynecologic origin of pain.
• Guarding: Voluntary contraction of abdominal muscles can indicate peritoneal irritation.
• Rigidity: Involuntary contraction of abdominal muscles can indicate peritoneal irritation.
• Blumberg’s sign: Rebound tenderness can indicate peritoneal irritation.
• Tanyol’s sign: Umbilical displacement can indicate pelvic or abdominal swelling.
• Beevor’s sign: Upward movement of the umbilicus during abdominal contraction can indicate specific nerve lesions.
• Murphy’s sign: Pain with deep breathing during right upper quadrant palpation can suggest acute cholecystitis.
• Boa’s sign: Skin hyperaesthesia over the posterior right ribs can indicate acute cholecystitis.
• Ranshoff sign: Yellowing of the umbilical area can indicate a ruptured common bile duct.
• Kenaway’s sign: Specific venous hums can indicate portal hypertension.
• Guy-Mallet sign: Tenderness upon left subcostal palpation can indicate pancreatitis.
• Sentinel-loop sign: Dilated jejunal loop on X-ray can indicate pancreatitis.
• Colon cut-off sign: Isolated distention of the transverse colon on X-ray can indicate pancreatitis.
• “Renal halo” sign: Edematous fluid around the kidney on X-ray can indicate pancreatitis.
• Fox’s sign: Bruising over the inguinal ligament can indicate hemorrhagic pancreatitis.
• Reversed ‘3’ sign: Widening of the duodenal loop on barium meal can indicate pancreatic cancer.
• Courvoisier’s sign: A palpable, non-tender gallbladder in a jaundiced patient can indicate pancreatic cancer.
• Bird’s beak sign (Barium swallow): Tapering of the distal esophagus on barium swallow can indicate achalasia.
• Rat tail sign (Barium swallow): Long stenotic segment on barium swallow can indicate esophageal carcinoma.
• Kalokerino’s sign: Filling defect of the stomach fundus can indicate cardio-esophageal herniation.
• String sign: Elongated pyloric channel on X-ray can indicate pyloric stenosis.
• Shoulder sign: Bulge of pyloric muscle on X-ray can indicate pyloric stenosis.
• Double tract sign: Parallel streaks of barium in the narrow channel can indicate pyloric stenosis.
• Cushion sign: Endoscopic finding of a cushioned mass can indicate gastric lipoma.
• Troisier’s sign: Enlarged left supraclavicular lymph node can indicate gastric cancer.
• Trousseau’s sign (gastric cancer): Migratory thrombophlebitis can indicate gastric cancer.
• Double bubble sign: Air in stomach and duodenum on X-ray can indicate malrotation or duodenal atresia.
• Coffee bean sign: X-ray finding indicating sigmoid volvulus.
• Dance’s sign: Right upper quadrant mass due to absence of bowel in the right lower quadrant can indicate intussusception.
• Target sign (AXR): Two concentric circles of fat density on X-ray can indicate intussusception.
• Target or donut sign (USG): Single hypoechoic ring with hyperechoic center on ultrasound can indicate intussusception.
• Pseudokidney sign (USG): Superimposed hypoechoic and hyperechoic layers on ultrasound can indicate intussusception.
• Kantor’s String sign: Thread-like terminal ileum on barium enema can indicate Crohn’s disease.
• Lead pipe appearance: Loss of haustrations on barium enema can indicate ulcerative colitis.
• Klein’s sign: Right iliac fossa pain that moves to the left can indicate Meckel’s diverticulum.
• Howship-Romberg sign: Pain in the inner knee can indicate strangulated obturator hernia.
• Hannington-Kiff sign: Loss of adductor reflex can indicate strangulated obturator hernia.

Groin and Other Signs

• Prehn’s sign: Relief of pain by elevating the testicle can indicate epididymo-orchitis.
• Vermooten’s sign: Doughy or absent prostate on rectal exam can indicate urethral rupture.
• Blue-dot sign: Torsion of testicular appendages.
• Silk glove sign: Indirect hernia sac in a pediatric patient.
• Stemmer sign: Inability to pinch skin on the toe can indicate lymphedema.
• Hutchinson’s sign: Pigment in the nail area can indicate melanoma.
• Kelly’s sign: Visible peristalsis of the ureter during surgery.
• Drooping lily sign: Inferior displacement of calyces on intravenous pyelography can indicate neuroblastoma.
• Boomerang sign: Temporal tips of lateral ventricles on imaging can indicate hydrocephalus.
• Blueberry muffin sign: Subcutaneous blue nodules in neuroblastoma.
• Macewen’s sign: Cracked pot sound on head tapping can indicate hydrocephalus.
• Froment’s sign: Weakness of thumb adduction can indicate ulnar nerve palsy.
• Kanavel’s sign: Tenderness in the ulnar palmar crease can indicate infected ulnar bursa.
• Tinel’s sign: Finger paraesthesia with median nerve percussion can indicate carpal tunnel syndrome.
• Von Rosen’s sign: Click when flexing and adducting the hip can indicate congenital hip dislocation.
• Hamman’s sign: Subcutaneous emphysema over the neck and chest can indicate pneumomediastinum.
• Carnett’s sign: Loss of abdominal tenderness when contracting muscles can indicate intra-abdominal pain.
• Chandelier sign: Severe pelvic pain with cervical movement can indicate pelvic inflammatory disease.
• Fothergill’s sign: Abdominal wall mass that doesn’t cross midline can indicate rectus sheath hematoma.

Trauma Indcators:

• Raccoon/Panda sign: Periorbital discoloration (around the eyes) may suggest a basilar skull fracture.
• Battle’s sign: Bruising behind the ear, over the mastoid process, also points to potential skull base damage.
• Seat-belt sign: Abrasions or bruising mirroring a seat belt’s path across the abdomen can indicate internal organ damage.
• Cullen’s sign: Periumbilical bruising suggests bleeding within the abdominal cavity. (Also acute pancreatitis)
• Grey–Turner’s sign: Flank bruising may signal bleeding behind the abdominal lining. (Also acute pancreatitis)
• Kehr’s sign: Left shoulder pain, especially when lying down or with upper abdominal pressure, can be a sign of splenic rupture.
• Danforth’s sign: Shoulder pain upon inhalation may indicate hemoperitoneum.
• Balance’s sign: Specific flank dullness with shifting dullness can point to splenic rupture with internal bleeding.
• Coopernail’s sign: Bruising in the perineal or scrotal area may indicate a pelvic fracture.
• Destot’s sign: Scrotal hematoma can be a sign of pelvic fracture.