Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Contributor: Travis Barlock MD
Educational Pearls

  • Frank's sign is a curious physical exam finding first described in the literature in 1973
    • Bilateral earlobe creases are recognized as a marker of coronary artery disease and cerebrovascular disease
  • Some studies have found an increase in all-cause mortality in patients with bilateral diagonal earlobe creases
  • The pathophysiology is still not fully understood
    • One 2020 study found histopathological changes associated with diagonal earlobe creases, potentially linking them via a model of hypoxia/reoxygenation

References

  1. Elliott WJ, Karrison T. Increased all-cause and cardiac morbidity and mortality associated with the diagonal earlobe crease: a prospective cohort study. Am J Med. 1991;91(3):247-254. doi:10.1016/0002-9343(91)90123-f
  2. Nazzal S, Hijazi B, Khalila L, Blum A. Diagonal Earlobe Crease (Frank's Sign): A Predictor of Cerebral Vascular Events. Am J Med. 2017;130(11):1324.e1-1324.e5. doi:10.1016/j.amjmed.2017.03.059
  3. Stoyanov GS, Dzhenkov D, Petkova L, Sapundzhiev N, Georgiev S. The Histological Basis of Frank's Sign. Head Neck Pathol. 2021;15(2):402-407. doi:10.1007/s12105-020-01205-4

Summarized & Edited by Jorge Chalit, OMS4

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Episode 979: Oral vs Temporal Thermometers

Episode 979: Oral vs Temporal Thermometers

Contributor: Taylor Lynch, MD Educational Pearls: A recent study published in a pediatric journal in April 2025 compared temporal and oral thermometers Paired temperature measurements (temporal and o...

20 Loka 20253min

Episode 978: Delusional Parasitosis

Episode 978: Delusional Parasitosis

Contributor: Taylor Lynch, MD Educational Pearls: Delusional parasitosis is a subtype of the psychiatric condition delusional disorder Defined as a fixed, false belief of infestation by parasites or...

13 Loka 20253min

Episode 977: Amyloid Therapy and Stroke-like Events

Episode 977: Amyloid Therapy and Stroke-like Events

Contributor: Aaron Lessen, MD Educational Pearls: The cause of Alzheimer's disease is multifactorial, but the most widely suspected mechanism is the amyloid cascade hypothesis: Beta-amyloid proteins ...

6 Loka 20253min

Episode 976: Improvised Burr Hole in an Epidural Hematoma

Episode 976: Improvised Burr Hole in an Epidural Hematoma

Contributor: Alec Coston, MD Case Report Summary: A 17-year-old female involved in a motor vehicle collision presented to a rural emergency facility via personally operated vehicle. During workup and ...

29 Syys 20254min

Episode 975: Nursemaid's Elbow

Episode 975: Nursemaid's Elbow

Contributor: Aaron Lessen, MD Educational Pearls: What is a Nursemaid's Elbow? A condition in which an elbow gets partially pulled out of place (a radial head subluxation) Usually happens in kids und...

22 Syys 20253min

Episode 974: ACE Inhibitor Angioedema

Episode 974: ACE Inhibitor Angioedema

Contributor: Ricky Dhaliwal, MD Educational Pearls: Angioedema in anaphylaxis Histamine and mast cell-mediated pathway Treatment: First line: epinephrine for vasoconstriction and bronchodilation Se...

15 Syys 20255min

Emergency Medicine Cases with Dr. Barlock

Emergency Medicine Cases with Dr. Barlock

Contributors: Travis Barlock MD, Jeffrey Olson MS4 Feel free to use the cases below for your own practice. All of the scenarios are completely made up and designed to hit several teaching points. Case...

9 Syys 202553min

Episode 973: Meningitis Retention Syndrome

Episode 973: Meningitis Retention Syndrome

Contributor: Travis Barlock MD Educational Pearls: Meningitis retention syndrome is a relatively novel and rare clinical condition Aseptic meningitis + acute urinary retention One study reports an i...

8 Syys 20252min

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