List of eponymous medical signs

Eponymous medical signs are those that are named after a person or persons, usually the physicians who first described them, but occasionally named after a famous patient. This list includes other eponymous entities of diagnostic significance; i.e. tests, reflexes, etc.

Sign Name Specialty Associated conditions External link
(if no internal link)
Descriptor
Aaron's sign Charles Dettie Aaron surgery appendicitis epigastric pain with pressure on McBurney's point
Abadie's sign Jean Marie Charles Abadie endocrinology Graves' disease levator palpebrae superioris spasm
Abadie's symptom Joseph Louis Irenée Jean Abadie neurology tabes dorsalis absence of pain on Achilles tendon pressure
Abderhalden reaction Emil Abderhalden obstetrics pregnancy serum reaction;obsolete
Abelin reaction Isaak Abelin infectious disease syphilis presence of arsenical anti-syphilitic;obsolete
Addis count Thomas Addis nephrology pyelonephritis quantitative cells and casts in 24hr. urine
Adie pupil William John Adie neurology ciliary nerve damage dilated pupil, poorly reactive but with normal near accommodation
Adson's sign Alfred Washington Adson vascular surgery thoracic outlet syndrome obliteration of radial pulse with manoeuvres
Alexander's law Gustav Alexander neurology, neurosurgery, ENT vestibular lesions describes nystagmus in vestibular lesions
Allen's test Edgar Van Nuys Allen vascular surgery, critical care[1] arterial supply of the hand tests for presence of palmar ulnar-radial anastomosis (palmar arch)
Apgar score Virginia Apgar obstetrics, pediatrics assess health of newborn
Apley grind test Alan Graham Apley orthopaedic surgery meniscal lesions manoeuvres to elicit knee pain
Argyll Robertson pupils Douglas Moray Cooper Lamb Argyll Robertson neurology neurosyphilis[2] light-near dissociation
Arneth count Josef Arneth haematology, nutrition folate deficiency lobulation of neutrophil nuclei
Asboe-Hansen sign Gustav Asboe-Hansen dermatology bullae extension of a blister to adjacent unblistered skin when pressed
Aschheim–Zondek test Selmar Aschheim, Bernhard Zondek obstetrics normal pregnancy synd/1834 at Who Named It? oestral reaction in mouse injected with pregnant urine
Aschoff body Karl Albert Ludwig Aschoff rheumatology, pathology rheumatic fever foci of interstitial inflammation in the myocardium and elsewhere
Ashby technique Winifred Ashby haematology, pathology haemolysis synd/233 at Who Named It? agglutination test for erythrocyte survival
Auberger's blood group Auberger (patient) haematology normal physiology synd/283 at Who Named It? Aua antigen
Auenbrugger's sign Josef Leopold Auenbrugger cardiology pericardial effusion synd/284 at Who Named It? bulging epigastrium
Auer rods John Auer hematology acute myeloid leukemia cytoplasmic inclusions in myeloblasts
Auspitz's sign Heinrich Auspitz dermatology psoriasis pinpoint bleeding when scales are removed from psoriasis or warts
Austin Flint murmur Austin Flint cardiology aortic insufficiency mid-diastolic rumble heard at apex
Babinski sign Joseph Babinski neurology abnormal plantar reflex Kumar SP, Ramasubramanian D (December 2000). "The Babinski sign—a reappraisal". Neurol India. 48 (4): 314–8. PMID 11146592. Retrieved 13 April 2009. dorsiflexion of the hallux with fanning of the remaining phalanges upon soft stimulation of the lateral plantar surface of the foot
Bainbridge reflex Francis Arthur Bainbridge cardiology normal physiology increase in heart rate with increase in circulating blood volume
Balbiani rings Edouard-Gérard Balbiani genetics RNA transcription synd/601 at Who Named It? large chromosome puff indicating site of RNA transcription
Ballance's sign Charles Alfred Ballance general surgery abdominal/splenic trauma percussive dullness left flank, LUQ, percussive resonance right flank
Bancroft's sign Joseph Bancroft vascular medicine deep vein thrombosis pain on anterior, but not lateral, compression of calf
Bárány test Robert Bárány ENT, neurology vertigo, vestibular dysfunction synd/595 at Who Named It? nystagmus elicited by hot or cold irrigation of ear canal
Barlow's maneuver Thomas Geoffrey Barlow, English Pediatric Orthopedist, (1915–1975) paediatrics, orthopaedic surgery hip dysplasia dislocation on adduction of hip
Bart hemoglobin Barts Hospital Obstetrics, pathology indicates a specific cause of death in some stillborns Loss of all four alpha-globin genes (total alpha-thalassemia) leads to severely anemic stillborn babies with small amounts of an abnormal hemoglobin composed of four gamma sub-units (Bart's Hemoglobin)
Bastian–Bruns sign Henry Charlton Bastian, Ludwig Bruns neurology spinal cord transection loss of muscle tone and reflexes below lesion level
Battle's sign William Henry Battle neurosurgery/traumatology basal skull fracture mastoid ecchymosis
Beau's lines Joseph Honoré Simon Beau dermatology, internal medicine multiple, including trauma transverse ridges on nails
Beck's triad Claude Schaeffer Beck cardiology cardiac tamponade hypotension, increased central venous pressure (JVP), distant heart sounds
Becker's sign Otto Heinrich Enoch Becker ophthalmology, endocrinology thyrotoxicosis visible pulsation of retinal arteries
Beevor's sign Charles Edward Beevor neurology, neurosurgery spinal trauma at T10 cephalad movement of navel on cervical flexion
Bekhterev–Jacobsohn reflex Vladimir Bekhterev, Louis Jacobsohn-Lask neurology pyramidal tract lesions stroking dorsal radial skin, with forearm in supination, elicits wrist and finger flexion
Bekhterev–Mendel reflex Vladimir Bekhterev, Kurt Mendel neurology pyramidal tract lesions toe flexion on percussion of dorsum of foot
Bence Jones protein Henry Bence Jones hematology multiple myeloma
Benedict solution Stanley Rossiter Benedict endocrinology diabetes mellitus reagent for presence of monosaccharides
Berger wave (rhythm) Hans Berger neurology normal physiology electroencephalographic alpha wave
Bezold–Jarisch reflex Albert von Bezold, Adolf Jarisch pharmacology, toxicology effect of certain alkaloids apnea, bradycardia, hypotension
Bielschowsky's head tilt test Alfred Bielschowsky neurology, ophthalmology lesions of cranial nerve IV test for palsy of superior oblique muscle
Bing's sign Paul Robert Bing neurology pyramidal tract lesions extension of the great toe on pricking the dorsum of the foot with a pin
Biot's respiration Camille Biot neurology brain stem herniation quick shallow respirations followed by period of apnea
Bitot's spots Pierre Bitôt ophthalmology vitamin A deficiency spots of keratin deposition in the conjunctiva
Bjerrum scotoma Jannik Peterson Bjerrum ophthalmology glaucoma comet shaped visual field defect, extending temporally from the physiological blind spot
Blumberg's sign Jacob Moritz Blumberg surgery peritonitis rebound tenderness
Boas' point Ismar Isidor Boas gastroenterology gastric ulcer dermal hyperaesthesia just left of T12
Boas' sign Ismar Isidor Boas gastroenterology acute cholecystitis dermal hyperaesthesia at inferior angle of R scapula
Bodansky unit Aaron Bodansky clinical chemistry unit of alkaline phosphatase concentration in blood
Boston's sign Leonard N. Boston ophthalmology, endocrinology thyrotoxicosis spasmodic ptosis on downward gaze
Bouchard's nodes Charles-Joseph Bouchard rheumatology osteoarthritis bony outgrowths on dorsa of proximal interphalangeal joints
Bracht–Wachter bodies Erich Franz Eugen Bracht, Hermann Julius Gustav Wächter cardiology infective endocarditis yellow-white spots in the myocardium
Branham's sign Henry Branham vascular surgery, nephrology chronic kidney disease, hemodialysis pressing on proximal portion of AV fistula results in bradycardia
Braxton Hicks contraction John Braxton Hicks obstetrics normal pregnancy "false labour". sporadic contractions beginning as early as mid 1st trimester
Brewer infarcts George Emerson Brewer nephrology, pathology pyelonephritis dark red wedge shaped areas on kidney section resembling infarcts
Brissaud's reflex Édouard Brissaud neurology pyramidal tract lesions plantar stimulation elicits contraction of tensor fasciae latae
Broadbent inverted sign Sir William Broadbent, 1st Baronet cardiology L atrial hypertrophy systole palpable in posterior chest wall
Broadbent sign Walter Broadbent cardiology adhesive pericarditis recession of L inferior intercostal spaces
Broca aphasia Paul Broca neurology, neuropsychology developmental or other pathology of various frontal cortical areas expressive aphasia
Brodie–Trendelenburg percussion test Sir Benjamin Collins Brodie, 1st Baronet, Friedrich Trendelenburg general medicine, surgery varicose veins superficial vein is percussed proximally; if impulse is felt over vein distally, valvular incompetence is present
Budin's sign Pierre-Constant Budin surgery, obstetrics suppurative mastitis if breast milk flown into a sterile pad is mixed with pus (brown, yellow or bloody traces), mastitis may be present
Brodie–Trendelenburg test Sir Benjamin Collins Brodie, 1st Baronet, Friedrich Trendelenburg general medicine, surgery varicose veins identifies level of valvular incompetence
Brudziński neck sign Józef Brudziński neurology meningitis neck flexion elicits hip and knee flexion
Brudziński cheek sign Józef Brudziński neurology meningitis pressure beneath zygoma elicits flexion of forearm
Brudziński symphyseal sign Józef Brudziński neurology meningitis pressure over symphisis pubis elicits knee, hip flexion and leg abduction
Brudziński reflex Józef Brudziński neurology meningitis passive flexion of knee to abdomen elicits flexion of contralateral hip and knee
Bruit de Roger Henri-Louis Roger paediatric cardiology ventricular septal defect loud pansystolic murmur
Bruns ataxia Ludwig Bruns neurology frontal lobe lesions difficulty moving feet in contact with floor, tendency to fall backwards
Bruns nystagmus Ludwig Bruns neurology cerebellopontine angle tumor, vestibular schwannoma nystagmus that coarsens in amplitude on lateral gaze
Brushfield spots Thomas Brushfield ophthalmology, genetics Downs' syndrome or non-pathological greyish-white spots at periphery of iris
Buerger's test Leo Buerger general medicine, surgery peripheral artery disease pallor of the leg upon elevation
Burton line Henry Burton toxicology lead poisoning NEJM 354:e21 5/18/06 blue discolouration of the gingival border
Cabot rings Richard Cabot hematology lead poisoning, anaemias threadlike strands in erythrocytes
Caput medusae Medusa gastroenterology, surgery portal hypertension distended veins radiating from umbilicus
Cardarelli's sign Antonio Cardarelli cardiology, thoracic surgery aortic arch dilatation or aneurysm, mediastinal tumour left displacement of trachea elicits palpable pulsation of same
Carey Coombs murmur Carey Coombs cardiology, rheumatology rheumatic fever mid-diastolic rumble
Carnett's sign John Berton Carnett primary care, surgery abdominal mass and/or pain Am J Med Sci 174 (1927): 579–599 supine patient lifts head from bed;↑ pain – abdominal wall ;↓ pain – intraperitoneal
Carvallo's sign José Manuel Rivero Carvallo cardiology tricuspid regurgitation increase in volume of murmur on inspiration
Casal collar Gaspar Casal nutrition pellagra (niacin deficiency) Casal collar at Medscape widely variable collar of dermatitis characteristically in c3,c4 dermatomes
Casoni test Tomaso Casoni infectious disease, tropical medicine hydatid disease intradermal injection of hydatid fluid causing wheal
Celsus signs of inflammation Aulus Cornelius Celsus various inflammation 1. Rubor (redness) 2. Tumor (swelling)3. Calor (heat) 4. Dolor (pain)
Chaddock reflex Charles Gilbert Chaddock neurology pyramidal lesions, corticospinal tract lesions extension of big toe with stimulation of skin over lateral malleolus
Chadwick sign James Read Chadwick obstetrics pregnancy cyanosis of vulva, vagina and cervix
Chagas disease Carlos Chagas infectious disease, tropical medicine heart failure Heart failure, enlarged esophagus, enlarged colon
Charcot's triad Jean-Martin Charcot surgery ascending cholangitis jaundice, fever and chills, RUQ pain
Charcot's triad Jean-Martin Charcot neurology multiple sclerosis nystagmus, intention tremor, staccato speech
Charcot–Leyden crystals Jean-Martin Charcot, Ernst Viktor von Leyden pathology any disorder characterized by eosinophil proliferation, e.g. ascariasis lysophospholipase crystals in various tissues
Cheyne–Stokes respiration John Cheyne, William Stokes palliative care respiratory center damage fluctuation between apnoea and tachypnoea
Churchill–Cope reflex Edward Delos Churchill, Oliver Cope cardiology heart failure distension of pulmonary vascular bed causes tachypnoea
Chvostek sign František Chvostek endocrinology hypocalcemia tapping over facial nerve elicits abnormal muscle contraction(s)
Claybrook sign Edwin Claybrook emergency medicine, surgery blunt abdominal trauma heart and/or breath sounds heard through abdominal wall indicate rupture of viscus
Clutton's joints Henry Hugh Clutton paediatrics congenital syphilis painless symmetrical hydrarthroses, particularly of the knees
Codman's triangle Ernest Codman oncology, orthopaedic surgery, radiology osteosarcoma, Ewing's sarcoma triangular subperiosteal growth
Comby sign Jules Comby paediatrics rubeola whitish patches on gingiva and buccal mucosa
Comolli's sign Antonio Comolli Orthopaedic surgery Scapular fracture "Comolli's sign". The Free Dictionary. Retrieved 29 May 2013. triangular swelling corresponding to the outline of the scapula
Coombs test Robin Coombs hematology hemolytic anemia
Coons fluorescent antibody method Albert Coons immunology Albert Coons at National Academies Press detection of antibodies by fluorescence microscopy using fluorescein-labelled antibodies
Cornell's sign Ethel L. Cornell, American Neuropsychologist and Psychiatrist, Columbia University NY (1882–1972) neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–8. scratching alongside big toe extensor tendon elicits an extensor plantar response
Corrigan pulse Dominic John Corrigan cardiology aortic insufficiency carotid pulsations with abrupt ascending and descending phases
Councilman body William Thomas Councilman infectious disease yellow fever, viral haemorrhagic fevers eosinophilic globules in liver
Courvoisier's law Ludwig Georg Courvoisier gastroenterology obstructive jaundice palpable gall bladder w/ painless jaundice unlikely to be cholelithiasis
Crichton-Browne sign Sir James Crichton-Browne neuropsychiatry 'general paresis' tremor at corners of mouth and of outer canthus
Crowe sign Frank W. Crowe dermatology neurofibromatosis type I axillary freckling
Cruveilhier–Baumgarten bruit Jean Cruveilhier, Paul Clemens von Baumgarten hepatology Cruveilhier–Baumgarten disease bruit around the umbilicus
Cullen's sign Thomas S. Cullen surgery, obstetrics intra-abdominal haemorrhage, ectopic pregnancy ecchymosis around umbilicus predicts onset of acute pancreatitis
Curschmann spirals Heinrich Curschmann pulmonology asthma spiral mucus plugs found in sputum
Cushing's triad Harvey Cushing neurology raised intracranial pressure elevated systolic bp, bradycardia, irregular respiration
Dagher Maneuver Nabil Dagher trauma surgery penetrating pelvic trauma bimanual palpation of foreign object lodged in pelvis with one digit in an incision lateral to the anus and the other digit inserted in the rectum
Dahlén–Fuchs nodules Johan Dahlén, Ernst Fuchs ophthalmology sympathetic ophthalmia granulocytic infiltrate of the uvea
Dahl's sign K.V. Dahl pulmonology COPD pigmented calluses on anterior surface of thighs (from leaning on elbows)
Dalrymple sign John Dalrymple ophthalmology, endocrinology thyrotoxicosis synd/494 at Who Named It? widened palpebral opening
Dance's sign Jean Baptiste Hippolyte Dance (paediatric)surgery ileo-cecal intussusception synd/3355 at Who Named It? empty RLQ (retracted right iliac fossa)
Darier's sign Ferdinand-Jean Darier allergy, dermatology urticaria pigmentosa dermatographia
Dawson's fingers James Walker Dawson neurology multiple sclerosis [1] [2] characteristic fingerlike appearance of lateral ventricle on mri, ct, or at autopsy
De Musset's sign Alfred de Musset cardiology aortic insufficiency head nodding in time with heartbeat
Dennie–Morgan fold Charles Clayton Dennie
DB Morgan
dermatology atopic dermatitis Dennie's line at TheFreeDictionary.com accentuated fold below the lower eyelid
Destot's sign Etienne Destot orthopaedic surgery pelvic fracture [3] ecchymosis superior to inguinal ligament, in scrotum or of thigh
Dix–Hallpike test Margaret R. Dix, Charles Skinner Hallpike otolaryngology Benign paroxysmal positional vertigo synd/3615 at Who Named It? Elicitation of extreme vertigo upon lateral movement of a patient's head when lying in a supine position
Döhle bodies Karl Gottfried Paul Döhle pathology various including trauma and neoplasm basophilic inclusions in peripheral cytoplasm of neutrophils
Doi's sign Hitoka Doi neurology Eaton–Lambert syndrome reappearance of absent deep tendon reflexes after short period of maximal muscle contraction
Dunphy's sign Osborne Joby Dunphy surgery appendicitis [4] increase in abdominal pain on coughing
Duroziez's sign Paul Louis Duroziez cardiology aortic insufficiency double bruit heard over femoral artery when it is compressed distally (see Traube's sign)
Elschnig spots Anton Elschnig ophthalmology hypertensive retinopathy
Epstein's pearls Alois Epstein paediatrics normal newborn cystic papules on palate
Ewart's sign William Ewart cardiology pericardial effusion percussive dullness, aegophony and bronchial breath sounds at L scapular tip
Faget sign Jean-Charles Faget infectious disease yellow fever Typhoid Fever tularaemia brucellosis others Faget's sign at Who Named It? the unusual constellation of fever and bradycardia
Finkelstein's test Harry Finkelstein rheumatology DeQuervain's tenosynovitis
Forchheimer spots Frederick Forchheimer paediatrics rubella small red spots on the soft palate
Fothergill's sign John Fothergill surgery rectus sheath hematoma anterior abdominal mass which does not cross the midline and is still palpable when abdominal wall muscles are tensed
Fox's sign George Henry Fox gastroenterology haemorrhagic pancreatitis ecchymosis of inguinal ligament (blood tracks retroperitoneally)
Frank's sign Sanders T. Frank cardiology ischaemic heart disease ear crease indicating risk of heart disease (disputed)
Friedreich's sign Nikolaus Friedreich cardiology constrictive pericarditis, tricuspid insufficiency collapse of distended neck veins in diastole
Froment's sign Jules Froment neurology ulnar nerve palsy patient required to hold paper between thumb and palm (against attempt to withdraw);ability to do so is assessed
Gallavardin phenomenon Louis Gallavardin cardiology aortic stenosis dissociation of musical and noisy elements in ejection murmur
Gamna–Favre bodies Carlos Gamna,
Maurice Favre
histology lymphogranuloma venereum Gamna-Favre bodies at Who Named It? basophilic cytoplasmic inclusion bodies
Gandy–Gamna nodules Charles Gandy,
Carlos Gamna
histology splenomegaly due to portal hypertension and sickle cell disease Gandy-Gamna bodies at Who Named It? small yellow-brown foci in the spleen
Garrod's pads Archibald Garrod dermatology repeated extreme tension of extensor tendon in interphalangeal joint thickening of skin and tissue over interphalangeal joint
Gerhardt's sign Carl Jakob Adolf Christian Gerhardt Gerhardt's sign at Who Named It?
http://cancerweb.ncl.ac.uk/cgi-bin/omd?Biermer's+sign
controversial[permanent dead link]: see references
Glasgow Coma Scale Glasgow neurology A neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial as well as subsequent assessment. The sum of Eye, Motor and Verbal responses.
Goetz sign Robert H. Goetz Patent Ductus Arteriosus Seen during right ventriculography in the setting of a patent ductus arteriosus, the Goetz sign refers to the negative contrast effect seen in the pulmonary artery from non-contrast enhanced blood shunting left to right from the aorta
Gonda's sign Viktor Gonda, Ukrainian Neuropsychiatrist, (1889–1959) neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–8. flexing then suddenly releasing the 4th toe elicits an extensor plantar response
Goodell's sign William Goodell obstetrics pregnancy softening of the vaginal part of the cervix during the first trimester
Goodsall's rule David Henry Goodsall gastroenterology, general surgery anal fistula anatomical relationships, differentiation of fistula types
Gordon's sign Alfred Gordon neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–8. squeezing the calf muscle elicits an extensor plantar response
Gottron's papules Heinrich Adolf Gottron rheumatology dermatomyositis Pathologic Basis of Disease (8th Ed), Robbins & Cotran Scaling, erythematous eruption or dusky red patches over the knuckles, elbows and knees
Gowers' sign[3] William Richard Gowers neurology muscular dystrophy
Graham Steell murmur Graham Steell cardiology mitral stenosis pulmonary regurgitation murmur in patients with pulmonary hypertension secondary to mitral stenosis
Grey Turner's sign George Grey Turner surgery retroperitoneal hemorrhage flank ecchymosis
Griffith's sign Alexander Hill Griffith, Scottish Ophthalmologist, Manchester (1858–1937) endocrinology Graves' ophthalmopathy (needed) lid lag of the lower eyelid on upward eye movement
Grisel's syndrome Pierre Grisel rheumatology non-traumatic subluxation of the atlanto-axial joint caused by inflammation of the adjacent tissues
Gunn's sign Robert Marcus Gunn ophthalmology hypertension Gunn's sign at Who Named It? AV "nicking" or "nipping" in hypertensive retinopathy
Hamman's sign Louis Hamman thoracic surgery oesophageal perforation w/ pneumomediastinum crepitus in sync w/ heartbeat but not respiration
Hampton's hump Aubrey Otis Hampton pulmonology, radiology pulmonary embolus with infarct Hampton's hump at Who Named It? wedge shaped consolidation at periphery with base on the pleura
Hampton's line Aubrey Otis Hampton radiology, gastroenterology peptic ulcer Hampton's line at Who Named It? line on barium meal indicating mucosal oedema associated with ulcer
Hannington-Kiff sign John G. Hannington-Kiff general surgery obturator hernia absent thigh adductor reflex with positive patellar reflex
Harrison's groove Edward Harrison internal medicine rickets Harrison's sulcus at Who Named It? rib deformity at the lower thorax
Hatchcock's sign ? paediatrics, infectious disease mumps (needed) tenderness behind angle of jaw (typically before swelling is evident)
Heberden's node William Heberden rheumatology osteoarthritis same as bouchard's nodes, but over dip joints
Hegar's sign Ernst Ludwig Alfred Hegar obstetrics normal pregnancy softening of cervical isthmus appearing between 4th and 6th weeks (usually)
Hess test Alfred Fabian Hess internal medicine capillary fragility Rumpel-Konchalevskii-Leede phenomenon or sign at Who Named It? appearance of petechiae after compression of arm by bandage or blood pressure cuff
Hildreth's sign DH Hildreth dermatology glomus tumor Relief of pain at tumor site upon vascular occlusion of limb, with acute return of pain on reperfusion
Hippocratic face Hippocrates palliative care impending death
Hippocratic fingers Hippocrates pulmonary medicine chronic hypoxia clubbing of distal phalanges
Hirschberg test Julius Hirschberg ophthalmology strabismus corneal reflection centred (-) or not centred (+) on pupil
Hoffmann's sign Johann Hoffmann neurology corticospinal tract lesions tapping distal phalanx of 3rd or 4th finger elicits flexion of same in thumb
Hollenhorst plaque Robert Hollenhorst ophthalmology hypertension, coronary artery disease, and/or diabetes cholesterol embolus(i) of retinal artery(ies)
Homans' sign John Homans thrombosis deep venous thrombosis knee bent, ankle abruptly dorsiflexed, popliteal pain
Hoover's sign (leg paresis) Charles Franklin Hoover neurology, psychiatry lower extremity paresis differentiates organic from non-organic etiology
Hoover's sign (pulmonary) Charles Franklin Hoover pulmonology COPD inward movement of lower ribs during inspiration
Howship–Romberg sign John Howship,
Moritz Heinrich Romberg
surgery obturator hernia Howship's syndrome at Who Named It? pain from an obturator hernia radiating to knee
Hutchinson's freckle Sir Jonathan Hutchinson dermatology melanoma Hutchinson's freckle at Who Named It? precancerous facial pigmentation
Hutchinson's pupil Sir Jonathan Hutchinson neurology oculomotor nerve lesion Hutchinson's pupil at Who Named It? dilated pupil on the side of an intracranial lesion due to IIIrd nerve compression
Hutchinson's sign Sir Jonathan Hutchinson ophthalmology herpes zoster Hutchinson's sign 2 at Who Named It? lesion on tip of the nose which can presage ocular herpes zoster
Hutchinson's teeth[4] Sir Jonathan Hutchinson pediatrics congenital syphilis small, widely spaced incisors with notched biting surfaces
Hutchinson's triad Sir Jonathan Hutchinson pediatrics congenital syphilis interstitial keratitis, nerve deafness, Hutchinson's teeth
Janeway lesion Theodore Caldwell Janeway cardiology infective endocarditis palmar or plantar erythematous or haemorrhagic papules
Jendrassik maneuver Ernő Jendrassik neurology hyporeflexia compares patellar reflex w/ and w/o distraction
Jobe's relocation test Christopher Jobe orthopedics
Joffroy's sign Alexis Joffroy endocrinology exophthalmos in Graves disease Joffroy's sign I at Who Named It? lack of forehead wrinkling when patient looks up with head bowed
Jolly's test Friedrich Jolly neurology myasthenia gravis or Eaton–Lambert syndrome electromyography test using repeated stimuli to show fatiguability in myasthenia
Jones criteria T. Duckett Jones rheumatology rheumatic fever criteria used to diagnose rheumatic fever
Kanavel's sign Allen B. Kanavel orthopedics, rheumatology tenosynovitis of flexor digitorum tendon http://www.emedicine.com/orthoped/TOPIC97.HTM (1) finger held in slight flexion, (2) fusiform swelling, (3) tenderness along the flexor tendon sheath, and (4) pain with passive extension of the digit.
Kayser–Fleischer ring Bernhard Kayser,
Bruno Fleischer
neurology, gastroenterology Wilson's disease (hepatolenticular degeneration) ring of brownish copper deposit at corneo-scleral junction
Kehr's sign Hans Kehr trauma surgery ruptured spleen referred pain to L shoulder
Kelly's sign Howard Atwood Kelly surgery, urology visible response of ureter when touched (means of identifying same)
Kerley lines Peter Kerley radiology pulmonary edema
Kernig's sign Woldemar Kernig neurology meningism, meningitis, subarachnoid haemorrhage synd/2200 at Who Named It? hip and knee fully flexed, extension of knee elicits pain and/or opisthotonus
Kocher's sign Emil Theodor Kocher ophthalmology, endocrinology Hyperthyroidism, Basedow's disease, In fixation on a fast upwards movement there occurs a convulsive retraction of the eyelid
Koebner's phenomenon Heinrich Koebner dermatology various conditions
Koeppe's nodules Leonhard Koeppe ophthalmology uveitis granulomatous nodules at pupillary margin
Koplik's spots Henry Koplik pediatrics measles
Korotkoff sounds Nikolai Korotkov cardiology auscultatory sphygmomanometry Korotkov described 5 sounds. Only the first (the onset of audible sound, and corresponding to systolic pressure) and the fifth (sound becomes inaudible, corresponding to diastolic pressure) are of practical clinical significance (however, see:Auscultatory gap)
Kussmaul breathing[5] Adolph Kussmaul endocrinology metabolic acidosis laboured deep breathing with normal or reduced frequency
Kussmaul's sign Adolph Kussmaul cardiology various, including right side failure increased jugular distension on inspiration
Kveim test Morten Ansgar Kveim pulmonary medicine sarcoidosis intradermal injection of lymphatic extract from known sufferer; obsolete
Lachman maneuver John Lachman orthopedic surgery anterior cruciate ligament injury modified anterior drawer test with knee in less flexion
Ladin's sign Louis Julius Ladin, Lithuanian-American Gynecologist, (1862–1951) obstetrics normal pregnancy (needed) softening of uterus; similar to Hegar's sign
Lancisi's sign Giovanni Maria Lancisi cardiology tricuspid regurgitation giant v-wave in seen in jugular vein
Landau–Kleffner syndrome William Landau, Frank Kleffner neurology, psychiatry aphasia aphasia and an abnormal EEG
Larrey's sign Dominique Larrey rheumatology sacroiliitis pain in sacroiliac area on sitting down on hard chair
Lasègue's sign Charles Lasègue neurosurgery, orthopaedic surgery lumbar disc lesions, sciatica better known as straight leg raise test
Leopold's maneuver Christian Gerhard Leopold obstetrics Leopold's maneuver at Who Named It? determination of fetal lie
Leser–Trélat sign Edmund Leser,
Ulysse Trélat
oncology malignant neoplasm Leser-Trélat sign at Who Named It? sudden onset of multiple pruritic seborrheic keratoses
Levine's sign Samuel A. Levine cardiology myocardial infarction patient clenches fist over chest when asked to describe pain
Lhermitte's sign Jean Lhermitte neurology lesions of cervical cord dorsal columns or caudal medulla, MS, chemotherapy, Behçet's disease electrical sensation down the back and into limbs with neck flexion or extension
Liebermeister's rule Carl von Liebermeister internal medicine Liebermeister's rule at Who Named It? For each fever degree Celsius an increase of 8 beats per minute in cardiac frequency
Lisch nodule Karl Lisch ophthalmology type I neurofibromatosis yellow brown hamartomata on iris
Lisker's sign ? internal medicine deep venous thrombosis (needed) tenderness on percussion of antero-medial tibia
Litten's sign Moritz Litten cardiology infective endocarditis eMedicine cotton-wool exudate in the retina
Lombard effect Étienne Lombard psychiatry malingering due to simulated deafness automatic rise in the loudness of a person's voice when they speak in noise
Louvel's sign ? internal medicine deep venous thrombosis (needed) increased pain along vein with Valsalva; proximal pressure prevents this
Lowenberg's sign Robert I. Lowenberg vascular medicine deep vein thrombosis (needed) immediate pain on inflating blood pressure cuff around calf
MacDonald triad John M. MacDonald psychiatry sociopathic personality disorder enuresis, firesetting and animal torture predictive of future criminal behaviour
Macewen's sign Sir William Macewen neurology, neurosurgery hydrocephalus, brain abscess resonance on percussion of fronto-temporo-parietal suture
Magnan's sign Valentin Magnan addiction medicine cocaine dependence Magnan's sign at Who Named It? feeling of moving foreign body under the skin
Mantoux test Charles Mantoux infectious disease tuberculosis intradermal protein derivative – diameter of wheal evaluated
Marcus Gunn pupil Robert Marcus Gunn ophthalmology, neurology severe retinal disease, lesion of optic nerve anterior to chiasm Gunn's pupillary phenomenon at Who Named It? Relative pupil dilatation when light swings to the affected side
Markle's sign George Bushar Markle IV surgery appendicitis (needed) RLQ pain on dropping from standing on toes to heels
Massouh's sign Farouk Massouh surgery appendicitis (needed) grimace of the patient upon a right sided (and not left) sweep.
Mayne's sign ? cardiology aortic insufficiency (needed) diastolic blood pressure drop of >15mmHg on raising arm
McBurney's point Charles McBurney surgery appendicitis 2/3 of the way lateral on a line from umbilicus to anterior superior iliac spine (corresponds to junction of vermiform appendix and cecum)
McConnell's sign M.V. McConnell cardiology pulmonary embolism echocardiography finding of akinesia of the mid-free wall of the right ventricle but normal motion of the apex
McMurray test Thomas Porter McMurray orthopaedics meniscal tear McMurray's sign at Who Named It? knee extended, valgus stress applied, leg rotated produces palpable or audible click
Means–Lerman scratch J. Lerman, J.H. Means endocrinology hyperthyroidism systolic heart murmur similar to pericardial rub
Mees' lines R.A. Mees toxicology arsenic or heavy metal poisoning transverse white lines across the nails
Meigs' syndrome Joe Vincent Meigs gynecology ascites with hydrothorax [https://pubmed.ncbi.nlm.nih.gov/10996681 Triad of ascites, hydrothorax and benign ovarian tumor
Mellinghoff's sign Karl Hermann Mellinghoff, German Endocrinologist, (1908–1967) hyperbaric medicine cutaneous decompression sickness coughing or Valsalve accentuates the venous markings of an erysipeloid rash
Mentzer index William C. Mentzer Jr. hematology microcytic anemia differentiates iron deficiency anaemia from beta thalassaemia
Miller Fisher test C. Miller Fisher neurology normal pressure hydrocephalus Improvement in cognitive function after withdrawal of CSF during lumbar puncture used to confirm diagnosis
Moniz sign António Egas Moniz neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–8. forceful plantar flexion of the ankle elicits an extensor plantar response
Möbius sign Paul Julius Möbius endocrinology thyrotoxicosis Möbius sign at TheFreeDictionary.com inability to maintain convergence of eyes
Muehrcke's lines Robert C. Muehrcke nephrology, oncology hypoalbuminaemia, chemotherapy paired transverse white lines on nail bed
Mulder's sign Jacob D. Mulder neurology, podiatry Morton's neuroma transverse compression of the forefoot elicits pain in the distribution of the affected nerve
Müller's maneuver Johannes Peter Müller pulmonology collapsed section of airway patient attempts to breathe in with nose and mouth closed (opposite of Valsalva maneuver)
Müller's sign Friedrich von Müller cardiology aortic insufficiency Müller's sign at Who Named It? visible pulsation or bobbing of uvula
Murphy's punch sign John B. Murphy urology perinephric abscess Murphy's punch at Who Named It? punch tenderness at the costovertebral angle
Murphy's sign John B. Murphy surgery cholecystitis Murphy's sign at Who Named It? hesitation on inspiration while gall bladder is palpated
Myerson's sign Abraham Myerson neurology Parkinson's disease inability to resist blinking when glabella is percussed
Naegele's rule Franz Karl Naegele gynecology gestation method of estimating due date
Nardi test George Nardi gastroenterology dysfunction of sphincter of Oddi administration of morphine and neostigmine reproduces sharp LUQ pain; not in general use
Nikolsky's sign Pyotr Nikolsky dermatology various, including pemphigus vulgaris shearing of epidermis under pressure
O'Brien's test ? https://mskmedicine.com/clinical_skills/obriens-test/ Assesses the integrity of the glenoid labrum and AC joint
O'Donoghue's triad D. O'Donoghue orthopaedics, sports medicine knee injury coincidence of anterior cruciate injury, medial collateral injury and meniscal tear
Oliver's sign William Silver Oliver cardiology aortic arch aneurysm caudal movement of trachea with systole
Oppenheim's sign Hermann Oppenheim neurology pyramidal tract lesions Oppenheim's reflex at Who Named It? irritation downward of the medial tibia causes dorsiflexion of big toe
Ortolani test Marino Ortolani pediatrics & orthopedics congenital hip dislocation Ortolani's sign and test at Who Named It? palpable clunk on moving hip
Osborn wave John Jay Osborn cardiology, emergency medicine hypothermia positive deflection at QRS-ST junction
Osler's node Sir William Osler internal medicine various, including SBE and SLE painful red lesions on the pads of the fingers and plantar surfaces
Osler's sign Sir William Osler internal medicine atherosclerosis falsely elevated bp reading due to incompressibility of calcified vessels
Palla's sign Antonio Palla internal medicine pulmonary embolism Pulmonary embolism at Merck Manual online enlarged right descending pulmonary artery on chest x-ray
Pastia's sign Constantin Chessec Pastia pediatrics scarlet fever Pastia's sign at Who Named It? lines of confluent petechiae in skin creases (associated with Scarlatiniform rash and strep pyogenes)
Patrick's test Hugh Talbot Patrick rheumatology sacroiliitis Patrick's test at Who Named It? external rotation of the hip causes pain
Peabody's sign C.N. Peabody internal medicine deep vein thrombosis calf muscle spasm when raising the affected leg with the foot extended
Pemberton's sign Hugh Pemberton thoracic surgery retrosternal mass with superior vena cava syndrome arms elevated over head elicits facial plethora, distended neck veins and inspiratory stridor
Phalen's maneuver George S. Phalen rheumatology, hand surgery carpal tunnel syndrome 30–60 seconds of full forced flexion of wrist elicits symptoms
Piskaçek's sign Ludwig Piskaçek obstetrics normal pregnancy Piskaçek's sign at Who Named It? palpable lateral bulge at tubal-uterine junction; present at 7–8 weeks
Plummer's nail Henry Stanley Plummer endocrinology thyrotoxicosis Plummer's nail at Who Named It? onycholysis especially of ring and little fingers
Pratt's sign Gerald H. Pratt internal medicine deep venous thrombosis pain elicited by compression of posterior calf
Prehn's sign Douglas T. Prehn urology testicular torsion no pain relief with lifting the affected testicle suggests testicular torsion
Queckenstedt's maneuver Hans Heinrich Georg Queckenstedt neurology spinal stenosis Queckenstedt's phenomenon at Who Named It? bilateral jugular vein pressure during lumbar puncture causes sudden rise in CSF pressure
Quincke's sign Heinrich Irenaeus Quincke cardiology aortic insufficiency Quincke's capillary pulse at Who Named It? visible pulsation in ungual capillary bed
Reynolds' pentad B.M. Reynolds gastroenterology ascending cholangitis Reynold's pentad at Who Named It? Charcot's triad + hypotension and altered mental state
Riesman's sign David Riesman endocrinology thyrotoxicosis bruit over globe of the eye
Rigler's sign[6] Leo George Rigler radiology, abdominal surgery pneumoperitoneum Rigler's sign at Who Named It? gas outlines both mucosal and serosal surfaces of bowel
Rinne test Heinrich Adolf Rinne ENT, neurology, audiometry hearing impairment Rinne's test at Who Named It? comparison of air conduction to bone conduction differentiates sensorineural from conductive deafness
Romaña's sign Cecilio Romaña tropical medicine Chagas' disease Romaña's sign at Who Named It? painless unilateral periorbital swelling
Romberg test Moritz Heinrich Romberg neurology dorsal column lesions, cerebllar lesions, alcohol intoxication Romberg's sign at Who Named It? inability to maintain posture with eyes closed
Rose's sign ? vascular medicine deep vein thrombosis (needed) Warm, stiff feeling of skin when affected leg is pinched
Rosenbach's test Ottomar Rosenbach clinical chemistry bilirubinuria Rosenbach's test at Who Named It? colour produced on addition of nitric acid
Rosenstein's sign Paul Rosenstein general surgery appendicitis Advances in Pediatrics. JP Medical Ltd. p. 1432. ISBN 978-93-5025-777-7. tenderness in the right lower quadrant increases when the patient moves from the supine position to a recumbent posture on the left side
Rossolimo's sign Grigory Ivanovich Rossolimo neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–8. percussion of the tips of the toes causes exaggerated flexion of the toes
Rotch sign Thomas Morgan Rotch cardiology pericardial effusion Rotch sign. (n.d.) Medical Dictionary for the Health Professions and Nursing. (2012). Retrieved September 6 2023 from https://medical-dictionary.thefreedictionary.com/Rotch+sign percussion dullness in the fifth intercostal space on the right
Roth's spots Moritz Roth ophthalmology, internal medicine various, including SBE and systemic vasculitides Roth's spot at Who Named It? retinal haemorrhages with pale centres seen at fundoscopy
Rovsing's sign Niels Thorkild Rovsing general surgery appendicitis Rovsing's sign at Who Named It? palpation of LLQ elicits pain in RLQ
Rumpel–Leede sign Theodor Rumpel,
Carl Stockbridge Leede
haematology capillary fragility Rumpel-Leede test at Who Named It? petechiae seen after compression by tourniquet
Russell's sign Gerald Russell psychiatry bulimia nervosa scarring of the dorsum of one hand (contact with incisors when purging)
Salus's sign Robert Salus ophthalmology hypertension Hypertension at Medscape deflection of retinal veins at right angle junctions due to elongation or shortening of connected arterioles
Schaeffer's sign Max Schaeffer neurology pyramidal tract lesions Schäffer's reflex at Who Named It? squeezing the Achilles tendon elicits an extensor plantar response
Schamroth's window test Leo Schamroth pulmonology, cardiology chronic hypoxia identifies clubbing of distal phalanges
Schiller's test Walter Schiller gynecology cervical cancer Schiller's test at Who Named It? affected areas of cervix fail to stain brown with iodine solution
Schilling test Robert F. Schilling internal medicine pernicious anaemia, coeliac disease, other malabsorption disorders B12 radioassay; rare
Schirmer's test Otto Schirmer ophthalmology keratoconjunctivitis sicca, as in Sjögren's syndrome quantifies lacrimal secretion
Schober test Paul Schober physiatry, rheumatology, orthopaedics various disorders of lumbar vertebrae Schober's sign at Who Named It? quantifies lumbar flexion
Sherren's triangle James Sherren surgery appendicitis Sherren's triangle at Who Named It? area of hyperaesthesia over the right lower abdomen
Shone's complex John D. Shone cardiology congenital heart defect supravalvular mitral ring, parachute deformity of mitral valve, subaortic stenosis and coarctation of the aorta
Siegrist streaks August Siegrist ophthalmology malignant hypertension hyperpigmented streaks parallel to choroidal vessels
Simmonds' test Franklin Adin Simmonds orthopaedics Achilles tendon rupture squeezing of calf fails to produce plantar flexion
Sims–Huhner test Harry M. Sims, Max Huhner reproductive medicine infertility Sims-Huhner test at Who Named It? determination of sperm count and motility in a sample taken from the cervical canal within an hour of intercourse
Sister Mary Joseph nodule[7] Sister Mary Joseph Dempsey (born Julia Dempsey) oncology various abdominal malignancies palpable lymph node in the umbilicus
Spurling's test Roy Glenwood Spurling neurology cervical radiculopathy Spurling's manoeuvre and sign at Who Named It? axial compression and rotation of cervical spine to the side of symptoms causes pain
Stellwag's sign Karl Stellwag von Carion endocrinology thyrotoxicosis infrequent and/or incomplete blinking, accompanied by Dalrymple's sign
Still's murmur Sir George Frederick Still paediatric cardiology subaortic stenosis, small Ventricular septal defect Still's mmurmur at Who Named It? systolic ejection sound ; vibratory/musical; best heard at left lower sternal border
Stransky's sign ? neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–18. sudden abduction and release of little toe causes extensor plantar response
Stroop test John Ridley Stroop neuropsychology various, including ADHD and schizophrenia reaction times for incongruent stimuli (e.g., word red printed in blue)
Strümpell's sign Adolph Strümpell neurology spastic pareses of the lower extremity Strümpell's sign I at Who Named It? failure of abrupt passive flexion of the hip and/or knee to elicit dorsiflexion and adduction of foot
Ten Horn's sign Carel Hendrik Leo Herman ten Horn surgery appendicitis pain in the right iliac fossa after traction of spermatic cord
Terry's nails R. Terry internal medicine various including hepatic failure white 'ground glass' nails;absence of lunula
Terry Thomas sign Terry-Thomas Orthopaedics Scapho-lunate dissociation Atlas of Signs in Musculoskeletal Radiology Gap between the scaphoid and lunate bones on AP wrist radiograph
Thomas test Hugh Owen Thomas Orthopaedics Fixed flexion deformity of hip Supine patient flexes one hip whilst keeping other leg flat; back arches if flexion deformity is present
Throckmorton's reflex Tom Bentley Throckmorton neurology pyramidal tract lesions The Babinski sign – a reappraisal Neurol India 48 (4): 314–8. pressure over dorsal big toe MTP joint elicits an extensor plantar response
Tinel's sign Jules Tinel neurology neuritis, compression disorders 'DTP' – distal tingling on percussion
Todd's paresis Robert Bentley Todd neurology seizure disorders focal weakness for as much as 48 hours after seizure
Traube's sign Ludwig Traube various splenomegaly dull percussion sound over Traube's space
Trendelenburg's sign Friedrich Trendelenburg neurology inferior gluteal palsy, other causes of hip abductors weakness pelvic tilt contralateral to 'stance leg'
Troisier's sign Charles Emile Troisier internal medicine, oncology Various abdominal malignancies, especially stomach cancer Troisier's node or sign at Who Named It? Enlargement of the left supraclavicular lymph node (=Virchow's node)
Trousseau's sign of malignancy Armand Trousseau internal medicine various malignancies, including pancreatic spontaneous thrombosis of multiple veins, including portal circulation
Trousseau's sign of latent tetany Armand Trousseau internal medicine, endocrinology hypocalcaemia Trendelenburg's phenomenon at Who Named It? in hypocalcaemia, occlusion of brachial artery induces carpal spasm
Uhthoff's phenomenon Wilhelm Uhthoff neurology multiple sclerosis Uhthoff's symptom at Who Named It? ↑ in neurological symptoms with exercise or other increase in body temperature
Unterberger test Siegfried Unterberger neurology, ENT vestibular lesions patient walks in place with eyes closed;direction of rotation indicates vestibular lesion on that side
Virchow's node Rudolf Virchow internal medicine, oncology Various abdominal malignancies, especially stomach cancer Virchow's node at Who Named It? Enlargement of the left supraclavicular lymph node (=Troisier's sign)
Virchow's triad Rudolf Virchow hematology etiology of thrombosis Hypercoagulability, Hemodynamic changes (stasis, turbulence) and Endothelial injury/dysfunction
Von Braun-Fernwald's sign Karl von Braun-Fernwald obstetrics pregnancy softening of the uterine fundus at the site of implantation at 4–5 weeks gestation
Von Graefe sign Albrecht von Graefe endocrinology Graves' disease ' lid lag'; immobility of upper lid on downward gaze
Wada test Juhn Atsushi Wada neurology epilepsy, anatomical lesions of cerebrum Wada's test at Who Named It? short acting barbiturate injected in internal carotid; lateralizes language function
Waddell's signs G. Waddell primary care, psychiatry chronic pain identify non-organic sources of low back pain
Waddell's triad J.P. Waddell paediatric trauma child pedestrian struck by motor vehicle Head trauma, thoracic and/or abdominal trauma, femoral fracture
Watson's water hammer pulse Sir Thomas Watson, 1st Baronet cardiology aortic regurgitation J. Suvarna Watson's water hammer pulse Journal of Postgraduate Medicine 2008-04-01 bounding forceful pulse elicited with postural manoeuvres
Wellens' sign or warning Hein Wellens cardiology severe stenosis of LAD characteristic ekg changes
Wernicke encephalopathy Carl Wernicke neurology, psychiatry thiamine deficiency neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular thiamine
Wernicke–Korsakoff syndrome Carl Wernicke, Sergei Korsakoff neurology, psychiatry Wernicke encephalopathy, Korsakoff syndrome combined presence of Wernicke encephalopathy (WE) and Korsakoff syndrome
Westermark sign Nils Westermark pulmonology pulmonary embolism Area of oligaemia on chest x-ray
Whipple's triad Allen Whipple endocrinology hypoglycemia 1.symptoms associated with hypoglycaemia 2. measured low serum glucose 3. relief of symptoms with administration of glucose p.o. or iv
Wickham's striae Louis Frédéric Wickham dermatology lichen planus white or greyish lines on the lichen planus lesions
Widal test Georges-Fernand Widal microbiology enteric fever serum agglutination; obsolete(?)
Winterbottom's sign Thomas Masterman Winterbottom tropical medicine trypanosomiasis posterior cervical chain adenopathy
Wolff–Parkinson–White triad Sir John Parkinson,
Paul Dudley White,
Louis Wolff
cardiology supraventricular tachycardia Wolff-Parkinson-White syndrome at Who Named It? pre-excitation on ECG
Wright's maneuver ? (needed)
Yeoman's test ? rheumatology sacroiliitis (needed) sacroiliac pain on rotation of ilium and extension of hip
Yergason's test ? orthopedic surgery bicipital tendinitis anterior shoulder pain with resisted supination of the forearm

Numerous additional signs can be found for Graves disease under Graves' ophthalmopathy.

See also

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References

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  1. ^ if the palmar arch is not present, radial artery stick for blood gases is contraindicated
  2. ^ Goldman, Lee. Goldman's Cecil Medicine (24th ed.). Philadelphia: Elsevier Saunders. p. 2446. ISBN 1437727883.
  3. ^ also called Gowers' manoeuvre
  4. ^ also called Hutchinson's incisors
  5. ^ or Kussmaul respiration
  6. ^ also called the double wall sign
  7. ^ also Sister Mary Joseph sign