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meralgia paresthetica

Etiology: - risk factors - obesity - diabetes mellitus - older age [3,4] - wearing tight-fitting pants or belts Pathology: - entrapment of the lateral femoral cutaneous nerve at the inguinal ligament Clinical manifestations: 1) paresthesias 2) sensory abnormalities (pain, paresthesias) on the anterolateral hip & thigh in the distribution of the lateral femoral cutaneous nerve 3) no motor symptoms (purely sensory nerve involvement) - loss of sensation on the anterolateral thigh 4) normal lumbar flexion, negative straight-leg-raising 5) no tenderness to palpation of lateral hip or mid thigh Differential diagnosis: - greater trochanteric pain syndrome - tenderness on palpation of the greater trochanter - diabetic amyotrophy - pain & weakness followed by wasting of pelvic & femoral muscles - may be unilateral or bilateral - lumbar radiculopathy - not localized to anterolateral thigh, low back pain Management: 1) weight loss 2) intramuscular hydrocortisone

Related

paresthesia; burning; tingling

General

entrapment neuropathy; nerve entrapment syndrome; pinched nerve

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1016-18
  2. Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2015
  3. Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  4. Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology. 2011 Oct 18;77(16):1538-42. PMID: 21975198 Free PMC Article
  5. NEJM Knowledge+ - Cheatham SW, Kolber MJ, Salamh PA. Meralgia paresthetica: a review of the literature. Int J Sports Phys Ther. 2013 Dec;8(6):883-93. PMID: 24377074 PMCID: PMC3867081 Free PMC article. - Patijn J, Mekhail N, Hayek S Meralgia Paresthetica. Pain Pract. 2011 May-Jun;11(3):302-8. PMID: 21435164 Review.