The Pemberton maneuver is a tool that may be utilized during the physical examination to demonstrate the presence of latent pressure in the thoracic inlet [1]. The maneuver is achieved by having the patient elevate both arms until they touch the sides of the face. A positive sign is marked by the presence of facial congestion and cyanosis, as well as respiratory distress after approximately one minute [2]. The sign is most commonly present in patients with substernal goiters where the goiter “corks off” the thoracic inlet [3]. We describe a 67-year-old Caucasian male with a positive Pemberton’s sign due to compression of the thoracic inlet by enlarged mediastinal nodes. The sign was amplified by the presence of a restrictive cardiomyopathy and constrictive pericarditis due to amyloidosis. We propose that a positive Pemberton’s sign should not be used exclusively to evaluate the probability of a substernal goiter, but rather to assess the potential for vascular compression due to pathological changes in the anatomical environment of the thoracic inlet.
| Published in | American Journal of Internal Medicine (Volume 2, Issue 3) |
| DOI | 10.11648/j.ajim.20140203.11 |
| Page(s) | 41-43 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2014. Published by Science Publishing Group |
Permberton’s Sign, Lymphadenopathy, Restrictive Cardiomyopathy, Constrictive Pericarditis, Geriatrics, Amyloidosis
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APA Style
Philip W. Tipton, Jeremy J. Blanchard, Will P. Guider, Jessica J. Keel, Allison D. Locke, et al. (2014). Revising the Exclusivity of Pemberton’s Sign: A Case Report. American Journal of Internal Medicine, 2(3), 41-43. https://doi.org/10.11648/j.ajim.20140203.11
ACS Style
Philip W. Tipton; Jeremy J. Blanchard; Will P. Guider; Jessica J. Keel; Allison D. Locke, et al. Revising the Exclusivity of Pemberton’s Sign: A Case Report. Am. J. Intern. Med. 2014, 2(3), 41-43. doi: 10.11648/j.ajim.20140203.11
AMA Style
Philip W. Tipton, Jeremy J. Blanchard, Will P. Guider, Jessica J. Keel, Allison D. Locke, et al. Revising the Exclusivity of Pemberton’s Sign: A Case Report. Am J Intern Med. 2014;2(3):41-43. doi: 10.11648/j.ajim.20140203.11
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Download@article{10.11648/j.ajim.20140203.11,
author = {Philip W. Tipton and Jeremy J. Blanchard and Will P. Guider and Jessica J. Keel and Allison D. Locke and Franchesca N. Robichaud and Adam Price and William L. Joyner and John K. Smith},
title = {Revising the Exclusivity of Pemberton’s Sign: A Case Report},
journal = {American Journal of Internal Medicine},
volume = {2},
number = {3},
pages = {41-43},
doi = {10.11648/j.ajim.20140203.11},
url = {https://doi.org/10.11648/j.ajim.20140203.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20140203.11},
abstract = {The Pemberton maneuver is a tool that may be utilized during the physical examination to demonstrate the presence of latent pressure in the thoracic inlet [1]. The maneuver is achieved by having the patient elevate both arms until they touch the sides of the face. A positive sign is marked by the presence of facial congestion and cyanosis, as well as respiratory distress after approximately one minute [2]. The sign is most commonly present in patients with substernal goiters where the goiter “corks off” the thoracic inlet [3]. We describe a 67-year-old Caucasian male with a positive Pemberton’s sign due to compression of the thoracic inlet by enlarged mediastinal nodes. The sign was amplified by the presence of a restrictive cardiomyopathy and constrictive pericarditis due to amyloidosis. We propose that a positive Pemberton’s sign should not be used exclusively to evaluate the probability of a substernal goiter, but rather to assess the potential for vascular compression due to pathological changes in the anatomical environment of the thoracic inlet.},
year = {2014}
}
TY - JOUR T1 - Revising the Exclusivity of Pemberton’s Sign: A Case Report AU - Philip W. Tipton AU - Jeremy J. Blanchard AU - Will P. Guider AU - Jessica J. Keel AU - Allison D. Locke AU - Franchesca N. Robichaud AU - Adam Price AU - William L. Joyner AU - John K. Smith Y1 - 2014/04/30 PY - 2014 N1 - https://doi.org/10.11648/j.ajim.20140203.11 DO - 10.11648/j.ajim.20140203.11 T2 - American Journal of Internal Medicine JF - American Journal of Internal Medicine JO - American Journal of Internal Medicine SP - 41 EP - 43 PB - Science Publishing Group SN - 2330-4324 UR - https://doi.org/10.11648/j.ajim.20140203.11 AB - The Pemberton maneuver is a tool that may be utilized during the physical examination to demonstrate the presence of latent pressure in the thoracic inlet [1]. The maneuver is achieved by having the patient elevate both arms until they touch the sides of the face. A positive sign is marked by the presence of facial congestion and cyanosis, as well as respiratory distress after approximately one minute [2]. The sign is most commonly present in patients with substernal goiters where the goiter “corks off” the thoracic inlet [3]. We describe a 67-year-old Caucasian male with a positive Pemberton’s sign due to compression of the thoracic inlet by enlarged mediastinal nodes. The sign was amplified by the presence of a restrictive cardiomyopathy and constrictive pericarditis due to amyloidosis. We propose that a positive Pemberton’s sign should not be used exclusively to evaluate the probability of a substernal goiter, but rather to assess the potential for vascular compression due to pathological changes in the anatomical environment of the thoracic inlet. VL - 2 IS - 3 ER -
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