An obese patient with a large panniculus presents with burning pain, numbness, and tingling over the upper outer thigh. It is worse when he bears down. He can demarcate the area affected; it is about 10x6 inches, oval-shaped, anterolateral thigh. Pinprick and light touch are affected. Straight leg test is negative. Deep tendon reflexes are all normal. Distal motor strength is normal. You don't notice any abnormalities in the hip, back, or sacroiliac joints.
Challenge: What nerve is involved? What is this called?
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I Never Learned This Nerve in Anatomy
This is lateral femoral cutaneous nerve entrapment, also called meralgia paresthetica. A purely sensory nerve, it is susceptible to compression, leading to pain and dysesthesia in the anterolateral thigh. Usually entrapment occurs as the nerve passes through the inguinal ligament (especially in an obese patient). It is often self-limiting and benign.
Source: UpToDate.
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