The Hoover Test is used to detect which issue in a patient reporting leg weakness?

• A. True joint pathology
• B. Neuropathy
• C. Malingering / non-organic weakness
• D. Myositis

Answer: (C)

The key idea is to test for consistency of effort, distinguishing real nerve/muscle problems from non-organic weakness or malingering. In the Hoover test, when the patient is asked to lift the affected leg, you place a hand under the heel of the opposite leg and look for the opposite leg to press down into the table as the patient exerts effort. If that downward pressure from the opposite leg is not felt (no force transferred to the examiner’s hand), it suggests the patient may not be genuinely trying to perform the motion, indicating non-organic weakness or malingering. If the opposite leg does press down as expected, it supports that the patient is capable of generating force and the reported weakness may be feigned or non-organic. This test does not diagnose true joint pathology, neuropathy, or myositis; those are organic conditions and the Hoover sign is specifically about detecting inconsistent effort.