Meralgia paresthetica: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
NadavNahumi (talk | contribs) |
||
| (5 intermediate revisions by the same user not shown) | |||
| Line 9: | Line 9: | ||
==Clinical Features== | ==Clinical Features== | ||
*[[Numbness]] and pain of anterolateral thigh | *[[Numbness]] and pain of anterolateral thigh | ||
**Usually unilateral with subacute onset | |||
*Pelvic compression test | *Pelvic compression test | ||
**Turn patient on side | **Turn patient on side | ||
**Compress pelvis | **Compress pelvis | ||
**If symptoms are relieved after 30s of lateral compression diagnosis is confirmed | **If symptoms are relieved after 30s of lateral compression diagnosis is confirmed | ||
<br> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hip pain DDX}} | {{Hip pain DDX}} | ||
'''Thigh Numbness''' | |||
*L3/L4 radiculopathy | |||
*Lumbosacral plexopathy | |||
*Femoral neuropathy | |||
==Evaluation== | ==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== | ==Management== | ||
*Usually self-limited with frequent spontaneous remission | |||
*Reduce pressure over the nerve in the groin area | |||
*[[NSAIDs]] | *[[NSAIDs]] | ||
*Weight loss | *Weight loss | ||
Latest revision as of 18:15, 23 March 2020
Background
- Entrapment of the lateral femoral cutaneous nerve usually in the inguinal canal
Etiology
- Intrapelvic (pregnancy, enlarging mass, aneurysm)
- Extrapelvic (trauma, tight garment or belt, obesity)
- Systemic (DM)
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
- Femur fracture
- Proximal
- Intracapsular
- Extracapsular
- Shaft
- Mid-shaft femur fracture (all subtrochanteric)
- Proximal
- Hip dislocation
- Pelvic fractures
Chronic/Atraumatic
- Hip bursitis
- Psoas abscess
- Piriformis syndrome
- Meralgia paresthetica
- Septic arthritis
- Obturator nerve entrapment
- Avascular necrosis of hip
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