Open AccessCommon Anatomical Variation in Patients with Idiopathic Meralgia Paresthetica: A High Resolution Ultrasound Case-Control Study
Author(s) -
Thomas Möritz
Publication year - 2013
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2013/16/e287
Subject(s) - medicine , anterior superior iliac spine , mononeuropathy , asymptomatic , surgery , ultrasound , thigh , radiology , endocrinology , diabetes mellitus , peripheral neuropathy
Background: Meralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneousnerve (LFCN) characterized by pain, numbness or paresthesia on the anterolateral aspect of thethigh. Though several contributing factors have been identified, the cause of its idiopathic form stillremains unclear. Anatomic and clinical studies have demonstrated a variable course for the LFCNand have suggested a contribution to the pathogenesis of MP.Objective: It was the aim of the present case-control study to assess the anatomical course andcompression site of the LFCN using high resolution ultrasound (HRUS) in patients suffering fromidiopathic MP, and compare the anatomical course in these patients to an asymptomatic controlgroup.Study Design: Case-control study.Setting: Nerve imaging center at a large university hospital in Austria.Methods: Twenty-eight patients with a diagnosis of MP were included in this study (20 men, 8women; mean age 54 years). The diagnosis was established by clinical history, physical examination,and diagnostic anesthetic block. Fifteen age- and gender-matched healthy volunteers served as thecontrol group.Standardized HRUS examinations were performed by one experienced radiologist from June 2004through April 2012. Two experienced radiologists reviewed the patients’ standardized HRUSexaminations and performed examinations in the control group to measure the minimal distancebetween the LFCN and the anterior superior iliac spine (ASIS).Outcomes: The minimal distance between the ASIS and the LFCN was measured using HRUS.Results: The LFCN could be seen in all patients and volunteers. In MP patients, the mean distancebetween the LFCN and the ASIS was 0.52 cm (SD 0.46 cm), compared to a mean distance of 1.79cm (SD 1.48 cm) in the control group (P < 0.001).Limitations: Limited sample size, retrospective design.Conclusions: The results of this study demonstrate a significantly different course of the LFCN,closer to the ASIS in patients with idiopathic MP.Key words: Ultrasound, meralgia paresthetica, entrapment neuropathy, assessment