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Pemberton Sign: A Recommendation to Perform Arm Elevation Spirometry With Flow-Volume Loops
Patrícia Naves Resende1, Marcelo Bezerra de Menezes1, Geruza Alves Silva1
1From the Pulmonary Division, Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Intrathoracic goiters can cause airway obstruction, even with normal spirometry. Arm elevation spirometry is crucial for detecting expiratory flow limitation in these cases.
Area of Science:
- Pulmonology
- Endocrinology
- Thoracic Surgery
Background:
- Intrathoracic goiters can compress the trachea and surrounding structures.
- Pemberton sign is indicative of thoracic inlet compression.
Observation:
- A case of intrathoracic goiter presented with a positive Pemberton sign.
- Initial conventional spirometry showed no respiratory abnormalities.
Findings:
- Arm elevation spirometry, using flow-volume loops, revealed expiratory flow limitation with a plateau.
- This suggests dynamic airway compression exacerbated by arm elevation.
Implications:
- Clinicians should consider arm elevation spirometry in suspected cases of intrathoracic goiter.
- This diagnostic approach can identify subtle airway compromise not detected by standard pulmonary function tests.
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