What is Ewart's sign?

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Last updated: February 12, 2025View editorial policy

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From the Guidelines

Ewart's sign is a physical examination finding indicative of a pleural effusion, specifically a dullness to percussion at the base of the lung with increased resonance on auscultation, which is often associated with cardiac causes of pleural effusion [no direct mention in 1, but based on general medical knowledge].

Key Points

  • The provided evidence does not directly mention Ewart's sign, but it discusses various methods for diagnosing the cause of pleural effusion, including echocardiography, thoracic ultrasound, and serum NT-proBNP levels 1.
  • Echocardiography is considered the standard initial diagnostic imaging modality in patients with suspected heart failure, and it can help identify findings consistent with systolic or diastolic heart failure, which may be associated with pleural effusion of cardiac origin 1.
  • Thoracic ultrasound can detect interstitial syndrome, simple pleural effusion, and sono-morphology consistent with simple compression atelectasis, which can support a cardiac origin of the pleural effusion 1.
  • Serum NT-proBNP levels can also be used to support a cardiac origin of the pleural effusion, with levels ≥1500 μg·mL−1 suggesting a cardiac cause 1.

Clinical Application

In clinical practice, a combination of these diagnostic methods, along with physical examination findings like Ewart's sign, can help determine the cause of a pleural effusion. However, it is essential to consider the patient's overall clinical presentation and medical history when interpreting these findings.

From the Research

Definition of Ewart's Sign

There are no research papers provided to directly answer the question about Ewart's sign.

Related Signs

However, the studies provided discuss various physical signs that can be used to diagnose different medical conditions, including:

  • Frank's sign: a diagonal skin fold between the tragus and the outer edge of the earlobe, which has been identified as an independent variable in coronary artery disease (CAD) 2, 3
  • Hoover's sign: a test used to differentiate between organic and functional weakness of pyramidal origin 4
  • Kehr's sign: a classical example of referred pain, where irritation of the diaphragm is signaled by the phrenic nerve as pain in the area above the clavicle 5

Key Points

  • The provided studies do not mention Ewart's sign explicitly.
  • The studies discuss the importance of physical signs in diagnosing medical conditions, such as coronary artery disease and neurological disorders.
  • Frank's sign, Hoover's sign, and Kehr's sign are examples of physical signs that can be used to diagnose specific medical conditions 2, 4, 5, 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hoover's sign: Clinical relevance in Neurology.

Journal of postgraduate medicine, 2014

Research

Traditional Kehr's sign: Left shoulder pain related to splenic abscess.

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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