Presentation
We present a patient with a spontaneous iliacus muscle hematoma, appearing immediately after a minor physical maneuver, presenting with pain and femoral neuropathy initially evidenced by massive quadriceps muscle fasciculations. [ncbi.nlm.nih.gov]
We report an unusual case of a 41 year old gentleman with a spontaneous iliacus haematoma causing a compressive femoral neuropathy, as a first presentation of Haemophilia B (Factor IX deficiency). [jnnp.bmj.com]
Musculoskeletal
- Thigh Pain
We describe a 58-year-old man who had progressive thigh pain, weakness, and numbness develop 13 years after cementless arthroplasty of his left hip. Plain radiographs showed substantial liner wear. [ncbi.nlm.nih.gov]
" combines four Greek roots to mean "thigh pain with anomalous perception". [en.wikipedia.org]
History A 67-year-old black woman presented one year prior to admission to this institution with left distal anterior thigh pain and left hip pain with an event of giving way of her left knee. [healio.com]
It is derived from the Greek word, meros, meaning thigh, and algo, meaning pain. It is a syndrome of paresthesia and pain in the lateral and anterolateral thigh. [davidhinman.com]
- Quadriceps Muscle Weakness
Admitted to the rehabilitation service 6 weeks after the fall, the patient was found to have a previously undiagnosed profound quadriceps muscle weakness. [ncbi.nlm.nih.gov]
Signs [ 12 ] These may include: Quadriceps muscle weakness and wasting. Loss of knee jerk. Numbness along the medial side of the thigh and anteromedial side of the calf (the L2-L4 dermatomes - see figures below). [patient.info]
- Thigh Weakness
CONCLUSIONS: Leg pain, thigh weakness, and atrophy are compatible with femoral neuropathy and are symptoms and signs compatible with recurrent large-bowel cancer. [ncbi.nlm.nih.gov]
Key points • Femoral neuropathy presents, often acutely, with thigh weakness, numbness, and variable pain. [medlink.com]
Neurologic
- Anterior Thigh Pain
History A 67-year-old black woman presented one year prior to admission to this institution with left distal anterior thigh pain and left hip pain with an event of giving way of her left knee. [healio.com]
Workup
CT with contrast is usually required in workup. Patients with progressive neurological dysfunction should be taken up for decompression to avoid permanent disability. Financial support and sponsorship Nil. [indjvascsurg.org]
Differentials Conditions to consider in the differential diagnosis of femoral mononeuropathy include the following (see Presentation and Workup): Vasculitic neuropathy Lumbar plexopathies Lumbosacral disk syndromes Anatomy Knowledge of femoral nerve anatomy [emedicine.medscape.com]
[…] and external rotation of the thigh has been associated with femoral neuropathy, particularly after prolonged surgery.29 Lumbar disc disease, specifically L3-L4 herniations, can present as peripheral femoral neuropathy and should be ruled out.30 The workup [healio.com]
Treatment
In the United States, duloxetine has been approved for the treatment of major depressive disorder, diabetic peripheral neuropathic pain and fibromyalgia in the adult population. [ncbi.nlm.nih.gov]
Non-somatic Treatment Psychological Treatment Depression Treatment Cognitive-Behavioural Treatment Rehabilitation Treatment Somatic Treatment Pharmacological treatment: Tricyclic antidepressants Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine [pijn.com]
Prognosis
The prognosis was excellent with almost complete recovery within 10 weeks. [ncbi.nlm.nih.gov]
Etiology
We report this unusual complication that followed major pelvic surgery and also review the literature and discuss the possible etiology for prevention of this injury. [tmu.pure.elsevier.com]
Use of prolonged digital pressure for post-procedural hemostasis is implicated as possible etiology. [ncbi.nlm.nih.gov]
Epidemiology
Working with ATs to identify and implement methods to obtain more specific diagnostic information via surveillance will help researchers better understand the epidemiology of peripheral nerve injuries. Publisher Full Text New Search Next [unboundmedicine.com]
Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40;1182–1189 PubMed CrossRef Google Scholar 6. [link.springer.com]
Epidemiology Femoral nerve lesions are uncommon. [patient.info]
Pathophysiology
The variability in clinical presentation of iatrogenic femoral nerve lesions, some new insights in their diverse pathophysiology, and in the diagnostic and treatment options are discussed with an update from the literature. [ncbi.nlm.nih.gov]
Prevention
We report this unusual complication that followed major pelvic surgery and also review the literature and discuss the possible etiology for prevention of this injury. [tmu.pure.elsevier.com]
Such complications can be prevented by minimising the procedural time, avoiding injury to the vessels and maintaining optimal posture of patient's thigh by limiting abduction and external rotation of hip. [ncbi.nlm.nih.gov]