Hoffmann’s Sign or Hoffmann Reflex for Neurological Screening of UMN Lesions

The Hofmann’s Sign is also referred to as “Digital reflex”, “Snapping reflex”, “Jacobson Sign” or “Trumner Sign”. When the spinal cord in the cervical spine gets compressed, chances are that the patient will exhibit pathological reflexes.  According to Grialwa et al.(2015), it has a sensitivity of 59% and a specificity of 49% to screen for upper motor neuron lesion (UMN lesions) that can lead to those pathological reflexes.

To test for the Hoffmann’s Sign, the patient isn’t sitting or standing position. Support the patient’s hand so that it is completely relaxed with the fingers partially flexed. You can kind of cradle the patient’s hand with your hand. Then grasp the patient’s middle finger, proximal to the distal interphalangeal joint, and then flick the patient’s nail of the middle finger with your thumb.

The test is positive if you’re able to observe quick adduction of the thumb and flexion of the index finger.

Other tests for UMN lesions:

• Babinski Sign
• L’Hermitté Sign

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Grijalva RA, Hsu FP, Wycliffe ND, Tsao BE, Williams P, Akpolat YT, Cheng WK. Hoffmann sign: clinical correlation of neurological imaging findings in the cervical spine and brain. Spine. 2015 Apr 1;40(7):475-9.