Meralgia paresthetica

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Background

  • Entrapment of the lateral femoral cutaneous nerve usually in the inguinal canal

Etiology

Clinical Features

  • Numbness and pain of anterolateral thigh
    • Usually unilateral with subacute onset
  • Pelvic compression test
    • Turn patient on side
    • Compress pelvis
    • If symptoms are relieved after 30s of lateral compression diagnosis is confirmed


Differential Diagnosis

Hip pain

Acute Trauma

Chronic/Atraumatic

Thigh Numbness

  • L3/L4 radiculopathy
  • Lumbosacral plexopathy
  • Femoral neuropathy

Evaluation

  • History - tight fitting clothes/ belts, recent weight gain, worse with valsalva or prolonged walking
  • Neurologic exam - diminished sensation in the distribution of the lateral femoral cutaneous nerve
    • Rule out weakness or reflex changes that would suggest an alternative diagnosis
  • Imaging - generally not necessary, unless atypical symptoms or concern for radiculopathy/ plexopathy
  • Nerve conduction studies (NCS)/ Electromyography (EMG) - generally not necessary, unless atypical symptoms or concern for radiculopathy/ plexopathy

Management

  • Usually self-limited with frequent spontaneous remission
  • Reduce pressure over the nerve in the groin area
  • NSAIDs
  • Weight loss
  • Corticosteroid injection

See Also

References