Orthopedic case of the week – April 20, 2022

Meralgia paresthetica is a relatively uncommon condition that results in numbness and pain over the anterior and lateral thigh. It is caused by compression of the lateral femoral cutaneous nerve as it exits the pelvis.
One month ago, 55 year old male presented with a 10 year history of numbness in his lateral thigh down to his knee. Pain was slowly progressive and had developed into burning and occasional sharp pain. Physical therapy had provided no improvement. After discussing the problem (meralgia paresthetica) and treatment options, patient decided to have a nerve hydrodilitation injection procedure in the office. This is a simple procedure to expand the tissues about the nerve to decrease the nerve pressure and improve symptoms. This procedure is covered by insurance and can be performed for many pinched nerves including carpal tunnel and ulnar nerve among others.
Patient came in today for follow up 1 month after procedure. His symptoms are 80% better. The burning and sharp pain are gone. He still has some numbness (which may be permanent after 10 years of symptoms).

Injection Needle outlined in red. Nerve green. S is sartorious muscle. TFL is tensor fascia lata.
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