Meralgia Paresthetica: A Long-standing Performance-Limiting Cause of Anterior Thigh Pain in a Soccer Player

the american journal of sports medicine

Bülent Ulkar, MD, Yusuf Yildiz and Burak Kunduracioglu

The American Journal of Sports Medicine

2003, Vol 31, pages 787-789

Clinicians from the Department of Sports Medicine at the University of Ankara, Turkey have reported a rare case of Meralgia Paresthetica in a 21-year-old male soccer player. He had a 6-month history of severe thigh pain and temporary numbness, which was aggravated by exercise. This had started 10 months earlier when he sustained a dead leg to the front of his thigh. This had initially responded well to conservative treatment and the player had returned to training after a couple of weeks.

However, the decreased sensation and numbness had continued to cause problems. MRI did not reveal any obscure pathologic lesions. Five milliliters of lidocaine was injected over the affected point, with the result that his pain subsided within minutes. Normal results were obtained from blood tests that included blood count, erythrocyte sedimentation rate, liver and kidney function tests, fasting blood sugar level, rheumatoid factor, and C-reactive protein. The patient's urinalysis results were normal. Based on all of these findings, the diagnosis of meralgia paresthetica was made.

Meralgia paresthetica is an entrapment neuropathy of the lateral femoral cutaneous nerve. Few clinicians seem to be aware of the condition or recognise the symptoms. Diagnosis is mainly based on history and physical examination. Patients typically describe burning, coldness, lightning pain, deep muscle aching, tingling, frank numbness, or local hair loss on the front or side of the thigh. The symptoms can be variable - they may be mild and may resolve spontaneously or they may severely limit the patient for many years.

Surgical exploration was chosen as the method of treatment by the authors. The lateral femoral cutaneous nerve was found to be compressed by a fibrous band that crossed over it and was released by simple dissection. The patient's symptoms were immediately improved after the operation and, at his third follow-up visit, 8 weeks after surgery, he reported complete relief of symptoms. Surgery was the first choice of treatment in this particular case because the patient was a professional soccer player who needed urgent relief to return to his previous level of performance.

It should be kept in mind that malignant lesions compressing the nerve and metabolic disorders such as diabetes mellitus may also lead to lateral femoral cutaneous nerve neuropathy with symptoms of meralgia paresthetica.

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