Meralgia Paresthetica in a Male Collegiate Lacrosse Player

Abstract

Objective: To present a unique case of meralgia paresthetica. Background: A 21-year-old male collegiate lacrosse player fell, twisted his right leg, and felt a "pop" in his hip. Objective findings included: antalgic gait, mild palpable swelling, and tenderness to touch with limited range of motion due to pain. Joint stability tests were negative. Differential Diagnosis: Right hip abductor strain, hip sprain, trochanteric bursitis, or labral tear. Treatment: The physician's findings included deep hip pain that increased with hip scouring and pain with active and passive motion. The physician's diagnosis was hip sprain; treatment was to continue with ice and begin active progression for return to play. The athlete was treated over the next several days with warm whirlpools, stretching, and a hip flexor wrap. Ten days postinjury, the athlete played in a game, but in the fourth quarter came off the field stating he couldn't feel his thigh. The orthopedic physician evaluated the athlete and provided a differential diagnosis of right hip flexor strain and hip capsule sprain with numbness, possibly due to meralgia paresthetica. The physician ordered treatment to continue and began a regimen of 600 mg of ibuprofen three times per day and noted the athlete could continue to play. Uniqueness: The athlete did not show any symptoms of meralgia paresthetica for 10 days post initial injury. The meralgia paresthetica was most likely caused by swelling resulting from the hip sprain, in which the swelling compressed the lateral femoral cutaneous nerve (LFCN) against the inguinal ligament. Conclusions: Meralgia paresthetica may occur as a result of trauma and subsequent swelling of the inguinal region. A thorough evaluation of the hip must be conducted to ensure no motor neuron involvement is associated with the paresthesia symptoms. Key Words: meralgia paresthetica, lateral femoral cutaneous nerve, paresthesia, hip pain eralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneous nerve (LFCN) characterized by pain, paresthesia, and sensory loss in the anterolateral thigh.