Hoover's sign (pulmonary)

Hoover’s sign in pulmonology is one of two signs named for Charles Franklin Hoover.[1]

It refers to inward movement of the lower rib cage during inspiration,[2] - instead of outward as is normal - implying a flat, but functioning, diaphragm, often associated with COPD.[3] COPD, and more specifically emphysema, often lead to hyperexpansion of the lungs due to air trapping. The resulting flattened diaphragm contracts inwards instead of downwards, thereby paradoxically pulling the inferior ribs inwards with its movement.

See also


  1. "George Crile, Charles Hoover and John Phillips".
  2. Binazzi B, Bianchi R, Romagnoli I, et al. (February 2008). "Chest wall kinematics and Hoover's sign". Respir Physiol Neurobiol. 160 (3): 325–33. doi:10.1016/j.resp.2007.10.019. PMID 18088571.
  3. Garcia-Pachon E, Padilla-Navas I (May 2006). "Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease". Int. J. Clin. Pract. 60 (5): 514–7. doi:10.1111/j.1368-5031.2006.00850.x. PMID 16700846.
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