Hoover’s sign refers to the paradoxical inspiratory retraction of the rib cage and lower intercostal
interspaces. Normally, the costal margin moves minimally during the regular respiratory cycle. However, if it does, it moves outward and upward.
It is commonly seen in COPD. However, it may also be seen in numerous other conditions (i.e congestive heart failure, asthma, severe pneumonia etc.)
It results from alterations in dynamics of diaphragmatic contraction due to hyperinflation, resulting in traction on the rib margins by the flattened diaphragm.
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