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How to elicit Joffroy's sign an OSCE guide

In Joffroy's sign there is a lack of wrinkling of the forehead when a patient looks up with the head bent forwards

Joffroys sign is a sign of hyperthyroidism.It is elicited as follows
  • Patient's face is inclined downwards.
  • Patient attempts to look up.
  • Look  for absence of wrinkles on the forehead.