An elderly, thin woman complains of pain radiating from the groin down the medial aspect of the thigh, worse on hip extension and internal rotation, relieved by flexion. She has no palpable groin lump. CT shows a small hernia through the obturator canal. Which eponymous sign did she exhibit?

• A Hannington-Kiff sign
• B Howship-Romberg sign ✓
• C Romberg-Howell sign
• D Mackler triad

Explanation

The Howship-Romberg sign is pain along the medial thigh caused by compression of the obturator nerve by an obturator hernia, exacerbated by extension, abduction or internal rotation of the hip. It is classically seen in emaciated elderly women, in whom a wide pelvis and loss of fat make the obturator canal patulous. The Hannington-Kiff sign is absence of the adductor reflex in obturator hernia. Because the hernia is deep, it is often impalpable and diagnosed late.

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.