Wigns

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There are three categories of diagnostic data collected during the physical examination (sign, symptom, and that in between) but only two words to describe them.

Examination responses that are vocalized (and thus symptomlike) yet thought to be specific (hence signifiers) can be classified as wigns.

A wign is a subjective reaction to a provocative examination maneuver deemed to have some valid relationship to the underlying pathology.

This word is pronounced “whine” to remind us it is a spoken response, and its spelling echoes that of sign, reminding us likewise a wign is more definitive than a generalized complaint.

For example, the response to Tinel’s test can be considered a wign: pain or paresthesia is a subjective response, but the test is deemed positive only when the complaints match the distribution of the median nerve. (Radiating paresthesia to the fifth finger, ulnar nerve territory, would not be classified as positive.)

Other examples include Lasègue’s wign, Kernig’s wign, and Lhermitte’s wign, to name a few.

Because symptoms, unlike signs, pass through (and are affected by) the prism of patients’ perceptions, the diagnostic value of a wign may be appropriately less than a true sign.

References

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