Anesth Pain Med.  2017 Jan;12(1):81-84. 10.17085/apm.2017.12.1.81.

Concurrent meralgia paresthetica and radiculopathy of the left leg: A case report

• Kang KN
• Rhyu CJ
• Chon SW
• Choi YS
• Yoo JI
• Lim YS
• Bang YS
• Kim YU

• KMID: 2369673
• DOI: http://doi.org/10.17085/apm.2017.12.1.81

Abstract

Meralgia paresthetica (MP) is a painful mononeuropathy of the lateral femoral cutaneouse nerve (LFCN) characterized by localized symptoms of numbness, tingling, pain and paresthesia along the anterolateral thigh area. L4 and L5 radiculopathy is set of symptoms that include sharp, burning or shooting pain, which is usually localized to anterolateral leg area and along the dermatomal distribution. When symptoms of MP and lumbar disc disease occur together it is not easy to diagnose MP. We report a case of synchronous post-traumatic MP and radiculopathy due to intervertebral disc herniation at L3-4 and 4-5. A 59-year-old male patient was admitted to the emergency room with symptoms of low back pain with left severe L4, L5 radiculopathy. This patient also complained of numbness and paresthesia in the left anterolateral thigh. After detailed history taking and lateral femoral cutaneouse nerve block, he was diagnosed with MP.

Keyword

Intervertebral disc; Meralgia paresthetica; Paresthesia; Radiculopathy; Thigh

MeSH Terms

Burns
Emergency Service, Hospital
Humans
Hypesthesia
Intervertebral Disc
Leg*
Low Back Pain
Male
Middle Aged
Mononeuropathies
Nerve Block
Paresthesia
Radiculopathy*
Thigh

Figure

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  Fig. 1 Sagittal T2-weighted magnetic resonance imaging (MRI) showing L3-4-5-S1 stenosis, L3–4, L4–5 and L5–S1 disc degeneration (A). Axial view of MRI shows left foraminal disc protrusion at L3–4 (B), left subarticular disc protrusion at L4–5 (C), and right paracentral disc protrusion at L5-S1 (D).

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  Fig. 2 The contrast agent showed a filling defect of the left L4 and L5 nerve roots.

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  Fig. 3 An anteroposterior live fluoroscopic image taken during a contrast injection for a left L5 transforaminal epidural steroid injection (A). Lumbar lateral view revealing a contrast medium in the anterior epidural space (B).

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  Fig. 4 Ultrasound image of the lateral femoral cutaneous nerve in the short axis. FL: fascia lata, ASIS: anterior superior iliac spine, SM: Sartorius muscle, injection site of local anesthetics (white circle), the asterisk: the lateral femoral cutaneous nerve.

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