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|Year : 2019 | Volume
| Issue : 3 | Page : 928-929
Pelvic osteochondroma causing meralgia paresthetica
Lucas V B Magalhães, Felipe R Massardi, Samuel A C Pereira
Department of Nursing and Medicine, Federal University of Viçosa, Minas Gerais, Brazil
|Date of Web Publication||23-Jul-2019|
Dr. Felipe R Massardi
Departamento de Enfermagem e Medicina, Universidade Federal de Viçosa, Avenida PH Rolfs, S/N, Viçosa, Minas Gerais, CEP 36570-900
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
B Magalhães LV, Massardi FR, C Pereira SA. Pelvic osteochondroma causing meralgia paresthetica. Neurol India 2019;67:928-9
Meralgia paresthetica (MP) is a compression syndrome of the lateral femoral cutaneous nerve (LFCN). It mainly occurs due to entrapment, trauma, surgical intervention, or an expansive process, leading to dysesthesia in the anterolateral thigh. The incidence was estimated at 4.3 cases per 10,000 patient years and it is a common but misdiagnosed condition. We present a remarkable case and images with an uncommon etiology.
An 18-year old, right-handed male patient presented with a 9-month history of progressive paresthesia in the lateral right thigh, which was worse in the right lateral decubitus position. His examination revealed reduction of tactile and pain sensibilities in the lateral aspect of right thigh and thickening of the right iliac bone at palpation, compared to the left side. Nerve conduction studies showed a non-excitable right LFCN, and the amplitude was 8.8uV for the left LFCN. The right hip ultrasound showed a small bony projection on the inner aspect of the iliac wing, with a cartilaginous hood characterized by a fine homogeneous hypoechoic halo coating the outer surface of the bony projection, a finding characteristic of an osteochondroma [Figure 1]. Pelvic computed tomography (CT) and three-dimensional (3D) reconstruction showed a small bony projection on the inner surface of the right iliac wing, with a thin pedicle and an uninterrupted merger between the cortex and medulla of the host bone at the site [Figure 2] and [Figure 3]. This patient opted for treatment with physical therapy, without improvement. He declined surgery and was lost to follow-up.
|Figure 1: Right hip ultrasound showing a small bony projection on the inner aspect of the iliac wing, with a cartilaginous hood characterized by a fine homogeneous hypoechoic halo (white arrows) coating the outer surface of the bony projection|
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|Figure 2: Pelvic CT image showing a small bony projection on the inner surface of the right iliac wing, with a thin pedicle and an uninterrupted merger between the cortex and medulla of the host bone at the site (yellow arrow)|
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|Figure 3: 3D CT reconstruction showing a small bony projection on the inner surface of the right iliac wing (yellow arrow)|
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The findings are consistent with the diagnosis of osteochondroma in the exact topography of the LFCN path. Palpation of the inguinal region was essential to suspect this hypothesis.
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Conflicts of interest
There are no conflicts of interest.
| » References|| |
Ivins GK. Meralgia paresthetica, the elusive diagnosis: Clinical experience with 14 adult patients. Ann Surg 2000;232:281-6.
Cheatham SW, Kolber MJ, Salamh PA. Meralgia paresthetica: A review of the literature. Int J Sports Phys Ther 2013;8:883-93.
Onat SS, Ata AM, Ozcakar L. Ultrasound-guided diagnosis and treatment of meralgia paresthetica. Pain Physician 2016;19:667-9.
[Figure 1], [Figure 2], [Figure 3]