What maneuver would elicit medial thigh pain in the presence of an obturator hernia?

An obturator hernia occurs when abdominal contents protrude through the obturator canal, which is located in the pelvis near where the obturator nerve navigates. This condition is particularly notable for presenting with referred pain in the medial thigh because the obturator nerve supplies the adductor muscles of the thigh and provides sensory innervation to the skin in that region.

The maneuver of internal rotation and extension of the hip would place tension on the structures surrounding the obturator canal, potentially worsening the hernia and stimulating the obturator nerve. This action can lead to increased pain in the medial thigh due to the nerve involvement. The pain elicited during this movement is often indicative of an irritative process nearby, such as in the case of an obturator hernia.

Conversely, actions like deep knee bends, external rotation of the hip, or leg raises would not adequately reproduce the specific pain associated with an obturator hernia, as they do not engage the obturator nerve in a manner that would lead to similar symptoms. Hence, internal rotation and extension of the hip is the specific maneuver that would result in medial thigh pain due to the anatomical and neurovascular relationships involved with an obturator hernia.