Reverse tripod sign: A novel clinical observation in respiratory distress

• Author Details:   
• Yuvarajan Sivagnaname ^*
• Praveen Radhakrishnan
• Cherukumalli Navya
• Sagana Ravikumar
• Durga K

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The tripod position is a well-recognised clinical sign in respiratory distress, commonly associated with obstructive airway diseases. This article introduces a novel postural variant—the Reverse Tripod Sign—characterised by patients leaning backwards or sitting upright with arms extended behind or laterally, bracing on a surface to relieve dyspnea. This posture was observed in at least 48 patients over one year, across a spectrum of chronic lung and neuromuscular conditions including COPD, pulmonary hypertension, interstitial lung disease, diaphragmatic weakness, and post-tuberculous sequelae. Recognising this sign may aid in bedside identification of severe disease and guide further diagnostic evaluation.

Keywords: Reverse tripod sign, Dyspnea posture, Pulmonary hypertension, Interstitial lung disease, Orthopnea, Diaphragmatic dysfunction.