Hildreth's Sign
Encyclopedia
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.
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.
of 92%, a specificity of 91%, a positive predictive value
of 92% and a negative predictive value
of 91% in diagnosing glomus tumors.
Glomus tumor
A glomus tumor is a rare benign neoplasm arising from the glomus body...
and hemangiopericytomas
Hemangiopericytoma
A hemangeopericytoma is a type of soft tissue sarcoma that originates in the pericytes in the walls of capillaries. When inside the nervous system, although not strictly a meningioma tumor, it is a meningeal tumor with an especially aggressive behavior.It was characterized in...
from other masses with a similar appearance. It was first described by DH Hildreth, in 1970.
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 sphygmomanometerSphygmomanometer
A sphygmomanometer or blood pressure meter is a device used to measure blood pressure, comprising an inflatable cuff to restrict blood flow, and a mercury or mechanical manometer to measure the pressure. It is always used in conjunction with a means to determine at what pressure blood flow is just...
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 sensitivitySensitivity and specificity
Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as classification function. Sensitivity measures the proportion of actual positives which are correctly identified as such Sensitivity and specificity are statistical...
of 92%, a specificity of 91%, a positive predictive value
Positive predictive value
In statistics and diagnostic testing, the positive predictive value, or precision rate is the proportion of subjects with positive test results who are correctly diagnosed. It is a critical measure of the performance of a diagnostic method, as it reflects the probability that a positive test...
of 92% and a negative predictive value
Negative predictive value
In statistics and diagnostic testing, the negative predictive value is a summary statistic used to describe the performance of a diagnostic testing procedure. It is defined as the proportion of subjects with a negative test result who are correctly diagnosed. A high NPV means that when the test...
of 91% in diagnosing glomus tumors.