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Clinical sign

A clinical sign is a sign that is evident to a doctor examining a patient.

It is not the same thing as ‘symptom’. For example, a patient may experience the symptom of ‘giving way’ but the doctor may observe a ‘pivot shift sign’ suggestive of a lax cruciate ligament.

Clinical signs apparent in routine examination. All doctors are taught a system of examination for each part of the body. Many important clinical signs will be evident just with ordinary examination, but these could be easily missed with careless observation eg:

• fluid inside the knee joint may be obvious when there is frank swelling, but a careful doctor can elicit early signs of ‘effusion’ (fluid in the joint space by tapping the patella (called ‘ballotting’ the patella) or stroking the side of the joint and eliciting a bulge on the other side.
• while observing a patient’s gait, the observant doctor may note the presence of ‘lateral thrust’, where the joint gives sideways as weight is taken on that side. This indicates an incompetent meniscus on the medial (inner) side.