HowshipRomberg

Howship-Romberg sign is a clinical symptom associated with specific pelvic or lower abdominal conditions. It is characterized by pain or a sensation of discomfort along the medial aspect of the thigh. This sign is typically indicative of irritation or compression of the obturator nerve, which provides sensory innervation to this area.

The sign is most commonly linked to obturator hernias, pelvic tumors, or other masses that exert pressure on the obturator nerve as it passes through the obturator canal. Patients with this sign often report pain radiating from the inner thigh to the knee, especially during hip adduction movements. It may also be accompanied by symptoms of underlying pathology, such as bowel obstruction in the case of hernias.

The physical examination involves eliciting pain by repositioning or applying pressure near the obturator foramen while the patient performs passive hip movement, primarily adduction. The presence of Howship-Romberg sign helps clinicians consider the diagnosis of obturator nerve compression or associated structures.

First described in the 19th century by the neurologists Auguste Howship and Moritz Romberg, the sign remains a valuable clinical tool in diagnosing rare but serious conditions like obturator hernias, which are more common in elderly, thin women. Due to its rarity and the nonspecific nature of thigh pain, the sign is often supplemented with imaging studies such as computed tomography (CT) scans for confirmation.

In summary, Howship-Romberg sign signifies obturator nerve irritation and plays an important role in the clinical assessment of pelvic or lower abdominal pathologies, especially when physical signs and patient history suggest nerve involvement.