Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Sharma R, Alsmair A, et al. Meralgia paraesthetica. Reference article, Radiopaedia.org (Accessed on 23 Apr 2024) https://doi.org/10.53347/rID-52249
Meralgia paraesthetica, also known as Bernhardt–Roth syndrome, refers to a mononeuropathy of the lateral femoral cutaneous nerve.
Patients often describe burning, coldness, lightning pain, deep muscle achiness, tingling, frank anesthesia, or local hair loss in the anterolateral thigh region.
It may result from either an entrapment neuropathy or a neuroma involving the lateral femoral cutaneous nerve. The nerve can also be injured by mechanical compression at the level of the inguinal ligament.
Ultrasound
Reported features include nerve abrupt caliber change, indistinct perineurium of the nerve, intraneural vascularity, or increased cross-sectional area 14.
Treatment and prognosis
Image-guided nerve block and steroid injection may play a role in selected cases.
History and etymology
It was first described by M Bernhardt in 1878, and in 1885, W Hager wrote up a case of a painful hip due to a traumatic injury of the lateral femoral cutaneous nerve 8-10. Ten years later, in 1895, M Bernhardt and V Roth independently published their experiences with meralgia paraesthetica, the latter term being coined by Roth. Hence its alternative moniker is "Bernhardt–Roth syndrome" 10-12.
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6. Tagliafico A, Serafini G, Lacelli F, Perrone N, Valsania V, Martinoli C. Ultrasound-Guided Treatment of Meralgia Paresthetica (Lateral Femoral Cutaneous Neuropathy): Technical Description and Results of Treatment in 20 Consecutive Patients. J Ultrasound Med. 2011;30(10):1341-6. doi:10.7863/jum.2011.30.10.1341 - Pubmed
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7. Ally R, Velleman M, Suleman F. Meralgia Paresthetica: Now Showing on 3T Magnetic Resonance Neurography. SA J Radiol. 2019;23(1):1745. doi:10.4102/sajr.v23i1.1745 - Pubmed
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8. Bernhardt M. Neuropathologische Beobachtungen. I. periphere Lahmungen. D Arch Klin Med. 1878;22:362–93.
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9. Hager W. Neuralgia femoris. Resection des Nerv. cutan. femoris anterior externus. Heilung. Deutsch Med Wochenschr 1885;11:218–9.
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10. Harney D & Patijn J. Meralgia Paresthetica: Diagnosis and Management Strategies. Pain Med. 2007;8(8):669-77. doi:10.1111/j.1526-4637.2006.00227.x - Pubmed
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11. Bernhardt M. Ueber Isolirt im Gebiete des N. cutaneous femoris externus vorkommende Parasthesien. Neurol Centrabl 1895;14:242–4.
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12. Roth V. [Meralgia Paresthetica]. Med Obozr 1895;43:678.
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13. Tagliafico A, Torri L, Signori A. Treatment of Meralgia Paresthetica (Lateral Femoral Cutaneous Neuropathy): A Meta-Analysis of Ultrasound-Guided Injection Versus Surgery. Eur J Radiol. 2021;139:109736. doi:10.1016/j.ejrad.2021.109736 - Pubmed
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14. Shi X, Liu F, Liu F, Chen Z, Zhu J. Sonographic Features of the Lateral Femoral Cutaneous Nerve in Meralgia Paresthetica. Quant Imaging Med Surg. 2021;11(10):4269-74. doi:10.21037/qims-21-209 - Pubmed
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