The Pemberton Sign
Authors: Clarissa Wallace
Journal: Annals of Internal Medicine (1996)

Brief Communications1 October 1996The Pemberton SignClarissa Wallace, MD, FRCPC and Kerry Siminoski, MD, FRCPCClarissa Wallace, MD, FRCPCFrom the University of Alberta, Edmonton, Alberta, Canada.Search for more papers by this author and Kerry Siminoski, MD, FRCPCFrom the University of Alberta, Edmonton, Alberta, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-7-199610010-00006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail With years of continued growth, the thyroid may extend downward and enlarge within the chest, resulting in a substernal goiter. Symptoms and signs may arise from compression of the structures located within the bony confines of the thoracic inlet, including the trachea, esophagus, and vasculature [1]. The Pemberton maneuver is a physical examination method that elicits manifestations of latent increased pressure in the thoracic inlet by altering arm position to further narrow the aperture. The maneuver involves “elevat[ing] both arms until they touch the sides of the head”; if the sign is present, “after a minute or so, congestion of ...References1. Katlic MK, Wang CA, Grillo HC. Substernal goiter. Ann Thorac Surg. 1985; 39:391-9. Google Scholar2. Pemberton HS. Sign of submerged goitre [Letter]. Lancet. 1946; 251:509. Google Scholar3. Sanders LE, Rossi RL, Shahian DM, Williamson DA. Mediastinal goiters. The need for an aggressive approach. Arch Surg. 1992; 127:609-13. Google Scholar4. Katlic MR, Grillow HC, Wang CA. Substernal goiter. Analysis of 80 patients from Massachusetts General Hospital. Am J Surg. 1985; 1949:283-7. Google Scholar5. Reeve TS, Rundle FF, Hales IB, Epps RG, Thomas ID, Indyk JS, et al. The investigation and management of intrathoracic goiter. Surg Gynecol Obstet. 1962; 115:223-9. Google Scholar6. Sy WM, Lao RS, Seo IS. Scintigraphic features of superior vena cava obstruction due to substernal non-toxic goitre. Br J Radiol. 1982; 55:301-5. Google Scholar7. Bailey H. Demonstrations of Physical Signs in Clinical Surgery. 11th ed. Bristol, England: IOP; 1949:115. Google Scholar8. Klaasen-Udding LM, Van Lijf JH, Ten Napel CH. Substernal goitre, deep venous thrombosis of the arm, and Pemberton's sign. Neth J Med. 1983; 26:228-31. Google Scholar9. Blum M, Biller BJ, Bergman DA. The thyroid cork. Obstruction of the thoracic inlet due to retroclavicular goiter. JAMA. 1974; 227:189-91. Google Scholar Author, Article, and Disclosure InformationAuthors: Clarissa Wallace, MD, FRCPC; Kerry Siminoski, MD, FRCPCAffiliations: From the University of Alberta, Edmonton, Alberta, Canada.Corresponding Author: Kerry Siminoski, MD, FRCPC, Endocrine Centre of Edmonton, Suite 608, 8215-112 Street, Edmonton T6G 2C8, Alberta, Canada.Current Author Addresses: Dr. Wallace: 202-301 East Columbia Street, New Westminster V3L 3W5, British Columbia, Canada. Dr. Siminoski: Endocrine Centre of Edmonton, Suite 608, 8215-112 Street, Edmonton T6G 2C8, Alberta, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Imminent Sign of SVC Syndrome Secondary to Retrosternal GoiterPemberton’s Sign for Superior Vena Cava CompressionPemberton signNontoxic GoiterThyroid and Its DisordersEtiologies and management of cutaneous flushingNontoxic GoiterPemberton Sign in a Male With Hashimoto’s HypothyroidismPemberton's Sign: Explained Nearly 70 Years LaterThyroid and Its DisordersThe respiratory systemThe endocrine systemRecurrent Unexplained Episodes of Facial Cyanosis and Shortness of Breath in Hunter DiseaseNontoxic Diffuse and Nodular GoiterThe Head and NeckReferencesThe Thyroid and Its DisordersDoença nodular de tireóideSymptomatologie et sémiologie des maladies respiratoiresManagement of Simple Nodular Goiter: Current Status and Future PerspectivesSíndrome de vena cava superior por bocio multinodularPosterior Mediastinal Goiters: Literature Review and Report of Three CasesCompression syndromes caused by substernal goitres 1 October 1996Volume 125, Issue 7 Page: 568-569 Keywords Computed axial tomography Swallowing Thorax Thyroid Thyroid-stimulating hormone Thyroxine Touch Trachea Triiodothyronine Veins ePublished: 15 August 2000 Issue Published: 1 October 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...