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Rehabilitation Practice and Science

Abstract

Meralgia paresthetica (MP) is a neuropathic pain syndrome resulting from compression or irritation of the lateral femoral cutaneous nerve (LFCN). Traditional diagnostic approaches rely on clinical assessments and electrodiagnostic testing. Ultrasound has emerged as a non-invasive, cost-effective modality for detailed visualization of the LFCN and guiding treatment interventions.

This review explores the anatomical considerations of the LFCN, its common etiological factors, clinical presentation, current management strategies, and ultrasound-guided injection techniques. While LFCN exhibits notable anatomical variability, and it is susceptible to external compression near the inguinal ligament. Some potential causes reveal as obesity, diabetes mellitus, or surgical interventions. Patients typically present with sensory disturbances in the anterolateral thigh. Non-operative management involves identifying extrinsic compression sources and modifiable risk factors. Pharmacologic options range from NSAIDs to neuropathic pain agents. Comparative outcomes suggest that neurectomy yields the highest and most durable symptom relief, followed by neurolysis. However, ultrasound-guided perineural injections, particularly with local anesthetics, offer a less invasive route to achieve meaningful short-term symptom relief, albeit with higher recurrence rates. Nevertheless, further prospective research is needed to refine patient selection criteria, procedural techniques, and long-term outcomes in ultrasound-guided approaches for meralgia paresthetica.

Additional Files
US-guided injection in MP.mp4 (8820 kB)
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