Femoral hernias are more common in women (unlike inguinal hernias), may be under diagnosed clinically and are at higher risk of complications, therefore, it is important to recognise the hernia on imaging. These descend via the femoral ring into the femoral canal, the most medial compartment of the femoral sheath. Delabrousse et al(1) describe a method using the pubic tubercle as a landmark in the differentiation of femoral, indirect and direct inguinal hernias. Suzuki et al(2) describe compression of the femoral vein as an aid to the confirmation of femoral hernia. Hyun Choi et al(3) also used a landmark method to determine the type of hernia. Unfortunately, given the variability of the location of the deep inguinal ring as described here, it is likely that one method alone may lead to errors.

1. Delabrousse E, Denue P, Aubry S, et al. The pubic tubercle: a CT landmark in groin hernia. Abdom Imaging. 2007. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17387542 [Accessed April 8, 2010].

2. Suzuki S, Furui S, Okinaga K, et al. Differentiation of femoral versus inguinal hernia: CT findings. AJR Am J Roentgenol. 2007;189(2):W78-83.

3. Choi J, Jang K, Kim M, et al. Differentiation of a Femoral Hernia from an Inguinal Hernia on Isotropic Multidetector-Row CT (MDCT): the Benefit of Inguinal Ligament Coronal-Oblique Images. J Korean Radiol Soc. 2009;60(4):259-265.