Osler's sign

Osler's Sign is a clinical finding named after the Canadian physician Sir William Osler. It is used in the diagnosis of pseudohypertension, a condition where the blood pressure appears to be elevated when measured with a sphygmomanometer, but is actually normal when measured directly.

Definition

Osler's Sign is defined as a palpable radial artery when the blood pressure cuff is inflated above the systolic blood pressure. This is due to the noncompressibility of the arteries, which is a characteristic of pseudohypertension.

Clinical Significance

Osler's Sign is used to differentiate true hypertension from pseudohypertension. Pseudohypertension is more common in elderly patients and those with severe atherosclerosis. It is caused by calcification of the arterial wall, which makes the artery rigid and noncompressible. This can lead to falsely elevated blood pressure readings when measured with a sphygmomanometer.

Diagnosis

The diagnosis of pseudohypertension is made by inflating the blood pressure cuff above the systolic blood pressure and then palpating the radial artery. If the artery is still palpable, this is considered positive Osler's Sign, indicating pseudohypertension. The diagnosis can be confirmed with direct intra-arterial blood pressure measurement, which is the gold standard.

Treatment

The treatment of pseudohypertension is controversial, as it is unclear whether it is harmful or not. Some studies suggest that it may be associated with an increased risk of cardiovascular events, while others do not. Therefore, the decision to treat should be individualized, taking into account the patient's overall cardiovascular risk profile.

See Also

• Hypertension
• Atherosclerosis
• Sir William Osler