National Physical Therapy Examination (NPTE) Practice Exam

A positive Stemmer's sign suggests which condition?

1. Dehydration

2. Thromboangiitis obliterans

3. Pulmonary embolism

4. Lymphatic disease

The correct answer is: Lymphatic disease

A positive Stemmer's sign is a clinical finding that indicates the presence of lymphatic disease, particularly lymphoedema. It is assessed through skin testing on the toes or fingers, where the inability to lift the skin at the base of the second toe suggests a swelling due to an underlying issue with lymphatic drainage. In cases of lymphoedema, there is an accumulation of lymph fluid in the interstitial spaces, leading to swelling that cannot be alleviated by elevating the limb. The positive Stemmer's sign specifically points to dysfunction in the lymphatic system, highlighting the importance of proper lymphatic drainage in maintaining fluid balance within the tissues. Other conditions, such as dehydration, thromboangiitis obliterans, and pulmonary embolism, do not present with a positive Stemmer's sign and are not primarily associated with lymphatic dysfunction. Dehydration typically relates to fluid loss rather than retention; thromboangiitis obliterans is a vascular condition affecting blood flow; and pulmonary embolism is a blockage in the pulmonary arteries, unrelated to lymphatic drainage issues. Thus, the connection of a positive Stemmer's sign with lymphatic disease is crucial for accurate clinical assessment and intervention.