higouménakis' sign higouménakis' sign higouménakis' sign is a unilateral enlargement of the sternoclavicular portion of the right clavicle, seen in congenital syphilis. higouménakis' signdifferential diagnosiscongenital syphilis the sign was named for george higoumenakis, who first described it in 1927 in the greek periodical proceedings of the medical society of athens (πρακτικά ιατρικής εταιρείας αθηνών). he subsequently published the description of the sign in a german article, making it more known among dermatologists.