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The lateral cutaneous nerve of the thigh passes from the lateral border of psoas major across the iliac fossa to pierce the inguinal ligament. It travels in a fibrous tunnel medial to the anterior superior iliac spine and enters the thigh deep to the fascia lata before continuing distally into the subcutaneous tissues:
Compression of the nerve as it passes through the inguinal ligament or as it pierces the fascia lata causes meralgia paraesthetica:
Characteristically, the patient complains of a burning or stinging sensation in the distribution of the nerve over the anterolateral aspect of the thigh. This is aggravated by walking or standing; it is relieved by lying down with the hip flexed:
Diagnosis is confirmed by the absence of motor signs and by excluding pelvic and intra-abdominal causes of irritation such as a tumour.
Conservative treatment is usually sufficient. Corsets and tight belts should be avoided. Local nerve blocks may be beneficial. Surgical interventions should be restricted to freeing the nerve; division may aggravate the original symptoms.
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