A 75-year-old woman presents with sudden onset of medial thigh pain and vomiting. On examination, there is tenderness in the medial thigh and pain exacerbated by adduction, extension, and internal rotation of the hip. A small, non-palpable hernia is suspected. What is the eponymous sign being described?

• A Howship-Romberg sign ✓
• B Barstow's sign
• C Aaron's sign
• D Psoas sign

Explanation

The Howship-Romberg sign is pain along the inner thigh exacerbated by adduction, extension, or internal rotation of the hip, characteristic of an obturator hernia. This occurs due to compression of the obturator nerve by the herniated contents. It is a classic but often missed finding in elderly, cachectic women. Aaron's sign is referred pain to the epigastrium in appendicitis. Psoas sign indicates appendicitis with retrocecal inflammation.

Reference: Sabiston Textbook of Surgery, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.