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Year : 2013  |  Volume : 59  |  Issue : 4  |  Page : 342

Respiratory Hoover's sign

Section of Respiratory Medicine, Hospital General Universitario, Elche, Spain

Date of Web Publication17-Dec-2013

Correspondence Address:
E Garcia-Pachon
Section of Respiratory Medicine, Hospital General Universitario, Elche
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0022-3859.123190

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How to cite this article:
Garcia-Pachon E, Padilla-Navas I. Respiratory Hoover's sign. J Postgrad Med 2013;59:342

How to cite this URL:
Garcia-Pachon E, Padilla-Navas I. Respiratory Hoover's sign. J Postgrad Med [serial online] 2013 [cited 2023 Sep 24];59:342. Available from:


Sekerci and Sarikcioglu [1] recently revised the characteristics of Hoover' sign for testing functional weakness in neurological patients. It should be noted that with the same eponymous term we can refer to a sign from the physical examination in respiratory patients. This respiratory Hoover's sign consists in the paradoxical inward movement of lower ribs during inspiration, and was first described [2] by the same physician, Charles Franklin Hoover (1865-1927), than described the neurological sign.

Hoover's sign is a very frequent finding in patients with chronic obstructive pulmonary disease (COPD), and its presence increases with the severity of the disease. [3] Because it is a sign easy to recognize in the clinical sitting, and with a relatively high agreement between observers, we proposed its use for detecting obstructive airway disease. [4] The presence of Hoover's sign in patients with COPD is independently related with higher values of dyspnea both at rest and on exertion, higher body mass index, number of exacerbations, and number of prescribed drugs for this disease. [3] Due to these characteristics, we consider that this respiratory Hoover's sign would be useful in predicting outcomes in COPD. [5]

In order to know whether one (neurologic or respiratory) sign predominates in the literature use, we have made a brief search on PubMed for Hoover's sign (and Hoover sign) in title/abstract. Thirty-tree references have been retrieved, 16 refer to the neurological Hoover's sign and 17 to the respiratory Hoover's sign. Consequently, physicians should be aware that the use of the eponymous term 'Hoover's sign' can refer to different clinical situations.

 :: References Top

1.Sekerci R, Sarikcioglu L. Hoover's sign. J Postgrad Med 2013;59:216-7.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Hoover CF. The diagnostic significance of inspiratory movements of the costal margins. Am J Med Sci 1920;159:633-46.  Back to cited text no. 2
3.Garcia-Pachon E, Padilla-Navas I. Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease. Int J Clin Pract 2006;60:514-7.  Back to cited text no. 3
4.Garcia-Pachon E. Paradoxical movement of the lateral rib margin (Hoover sign) for detecting obstructive airway disease. Chest 2002;122:651-5.  Back to cited text no. 4
5.Garcia-Pachon E, Padilla-Nava I. Predicting outcomes in chronic obstructive pulmonary disease. N Engl J Med 2004;350:2308-10.  Back to cited text no. 5


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2004 - Journal of Postgraduate Medicine
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