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Pemberton's sign is used to evaluate venous obstruction in patients with goiters. The sign is positive when bilateral arm elevation causes facial plethora. It has been attributed to a "cork effect" resulting from the thyroid obstructing the thoracic inlet, thereby increasing pressure on the venous system. According to some, the "cork effect" is caused by the thyroid descending into the thoracic inlet during arm elevation. According to others, the obstruction is due to elevation of the thoracic inlet against the thyroid.

Pemberton's Sign: Explained Nearly 70 Years Later