An 82-year-old thin, bedridden woman presents with colicky abdominal pain, vomiting, and pain radiating from the groin down the medial aspect of the thigh. Abdominal examination shows distension. CT shows a herniated loop of bowel through the obturator canal. The referred thigh pain described here is known by which eponym?

• A Murphy's sign
• B Hannington-Kiff sign
• C Boerhaave sign
• D Howship-Romberg sign ✓

Explanation

The Howship-Romberg sign is pain along the medial thigh extending toward the knee, caused by compression of the obturator nerve by an obturator hernia passing through the obturator canal. Obturator hernias occur typically in elderly, emaciated women, present with small bowel obstruction, and are easily missed because the hernia is hidden deep to the pectineus muscle. The Hannington-Kiff sign is an absent adductor reflex seen in the same condition, but it refers to the reflex, not the referred pain pattern.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.