A 34-year-old, obese, Caucasian male presents to your office with an abnormal sensation over his right thigh. He says, "It gets numb, and sometimes I feel burning over my thigh." He denies any back pain, muscle weakness, or abnormal sensation below the knee. His past medical history is insignificant. He smokes two packs of cigarettes and consumes 1-2 bottles of beer daily. He is a construction worker. He frequently works in a squatting position. Physical examination reveals an area of decreased sensation over the right anterolateral thigh. There is no muscle weakness. Deep tendon reflexes are symmetrical.
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Which of the following is the most likely cause of this patient's condition?

Question

Quizplus · Accepted Answer

Explanation: Meralgia paresthetica is a very common syndrome that is caused by the entrapment of the lateral femoral cutaneous nerve, which is a small, purely sensory nerve that is a direct branch of the lumbar plexus. It can be compressed as it courses from the lumbar plexus, through the abdominal cavity, under the inguinal ligament, and into the subcutaneous tissue of the thigh. Physical examination typically reveals an area of decreased sensation over the anterolateral thigh without any muscle weakness or deep tendon reflex abnormalities. (Choice C)A femoral nerve lesion causes anterior and anteromedial thigh paresthesia, but it is uncommon. It is accompanied by quadriceps muscle weakness and decreased knee jerk reflex. (Choices A and B)L5 and S1 radiculopathies are typically accompanied by back pain that radiates down the lateral or posterior aspect of the leg. Weakness of the muscles supplied by the corresponding segment is usually present. (Choice E)An obturator nerve lesion is characterized by sensory loss over the medial thigh and weakness in leg adduction. Educational Objective: Meralgia paresthetica is a very common syndrome that is caused by the entrapment of the lateral femoral cutaneous nerve. Physical examination typically reveals an area of decreased sensation over the anterolateral thigh without any muscle weakness or deep tendon reflex abnormalities.

A 34-Year-Old, Obese, Caucasian Male Presents to Your Office with an Abnormal