Obturator Hernia Should Be Considered In The Differential Diagnosis of Hip and Knee Pain

Abstract

Obturator hernia is a rare disease usually occurring in debilitated elderly women. Pain radiating down the medial thigh and knee (Howship-Romberg sign) is a specific sign of the disease. Presently described is a case of obturator hernia in a 73-year-old female patient who presented with severe left hip pain radiating down the medial thigh and knee, nausea, and loss of appetite. Initially, vertebral disc herniation was thought to be cause, but abdomino-pelvic computed tomography scan revealed left strangulated obturator hernia. Diagnosis of obturator hernia can be challenging. Physicians should consider obturator hernia in the differential diagnosis of knee and hip pain, and investigate for Howship-Romberg sign. Early diagnosis of the disease not only decreases morbidity and mortality, but also presents opportunity to treat with minimally invasive methods.

Posterior branch-type obturator hernia: a rare cause of hip pain

“…In the present case, the patient did not exhibit the Howship-Romberg sign but complained instead of severe hip joint pain on the affected side, which was exacerbated by hip flexion and external rotation. Although rare, obturator hernia presenting with hip pain has previously been reported 5–9. The hip pain may stem from compression of the articular branches of the obturator nerve, innervating the hip joint capsule.…”