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Meralgia paresthetica or meralgia paraesthetica is pain or abnormal sensations in the outer thigh not caused by injury to the thigh, but by injury to a nerve which provides sensation to the lateral thigh. Meralgia paresthetica is a specific instance of nerve entrapment. [5] The nerve involved is the lateral femoral cutaneous nerve (LFCN).
Entrapment of the lateral cutaneous nerve of the thigh is caused by compression of the nerve near the anterior superior iliac spine and the inguinal ligament. [2] This causes meralgia paraesthetica (Bernhardt-Roth syndrome). [2] [5] This may be diagnosed with ultrasound, which changes the morphology of the nerve. [1]
Sometimes compression occurs in areas that are not considered tunnels and where a nerve passes between two mechanically stiffer tissue types that can squeeze or pinch the soft nerve. Examples include the lateral femoral cutaneous nerve at the inguinal ligament [8] and the middle cluneal nerves at the long posterior sacroiliac ligament. [9]
The lateral cutaneous branch ("iliac branch") pierces the internal oblique muscles and the external oblique muscles immediately above the iliac crest. [4] It is distributed to the skin of the gluteal region, behind the lateral cutaneous branch of the subcostal nerve; the size of this branch bears an inverse proportion to that of the lateral cutaneous branch of the subcostal nerve.
The dorsal branch (ramus dorsalis; posterior branch) descends, along the dorsal surface of the radial side of the forearm to the wrist.. It supplies the skin of the lower two-thirds of the dorso-lateral surface of the forearm, communicating with the superficial branch of the radial nerve and the posterior cutaneous nerve of forearm of the radial nerve.
It provides sensory innervation to the lateral forearm (via its terminal branch). [3] It courses through the anterior part of the arm, terminating 2 cm above elbow; [citation needed] after passing the lateral edge of the tendon of biceps brachii it is becomes known as the lateral cutaneous nerve of the forearm. [3]
Cutaneous innervation of the upper limbs is the nerve supply to areas of the skin of the upper limbs (including the arm, forearm, and hand) which are supplied by specific cutaneous nerves. Modern texts are in agreement about which areas of the skin are served by which cutaneous nerves, but there are minor variations in some of the details.
Another branch observed, that is mentioned in passing in previous literature is the medial branch of the lateral sural cutaneous nerve. [3]In a 2021 study by Steele et al. (Annals of Anatomy), a medial branch of the lateral sural cutaneous nerve was observed in approximately 36% of lower extremities dissected (n=208) with an average diameter of 1.47 ± 0.655 mm with a 95% CI of 1.31 – 1.625 mm.