Hoffman's Test

Video Description

Hoffmann's test is a physical exam maneuver that is sensitive but not very specific for cervical myelopathy.

There are two methods to perform. The first is to hold and secure the middle phalanx of the long finger and then "flick" the distal phalanx into an extended position. Involuntary contraction of the thumb IP joint is a positive test.

The second way is to support the distal phalanx (examiners finger under distal phalanx) of the long finger and then "flick" the distal phalanx into an extended position. Involuntary contraction of the thumb IP joint is a positive test.

Malanga et al found the existing literature does not address interexaminer reliability but appears to indicate fair sensitivity and fair to good specificity for the Hoffman's sign.

References:
Malanga GA, Landes P, Nadler SF. Provocative tests in cervical spine examination: historical basis and scientific analyses. Pain Physician. 2003 Apr;6(2):199-205. Level of Evidence: 5 - Other.
PMID: 16883381 (Link to Abstract)