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.