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The lateral femoral cutaneous nerve or nervus cutaneus femoris lateralis in Latin is a strictly sensory nerve that originates from the dorsal divisions of the second and third lumbar ventral rami (L2, L3). It rises from the lateral border of the psoas major muscle, and crosses the iliacus muscle obliquely towards the anterior superior iliac spine. It then runs posterior or through the inguinal ligament, and anterior or through the sartorius muscle as it enters the thigh. There, it divides into anterior and posterior branches.
The anterior branch is superficial, and is located about 10 cm below the anterior superior iliac spine (ASIS). It supplies the skin of the anterior and lateral regions of the thigh as far as the knee. It connects with the cutaneous branches from the anterior division of the femoral nerve, as well as the infrapatellar branch of the saphenous nerve to form the peripatellar plexus. The posterior branch runs higher than the anterior, pierces the fascia lata, and divides to supply the skin on the lateral surface of the thigh, from the greater trochanter to the midthigh. In some cases, it supplies the gluteal skin as well.
The lateral femoral cutaneous nerve of the thigh is susceptible to entrapment at three sites along its course. These sites are: close to the vertebral column, within the abdominal cavity as it runs across the pelvis and just as it leaves the pelvis. The last being the most commonly damaged site. The passage of the nerve deep to the tendinous fibers of the inguinal ligament and the formed angulation as it crosses the iliac crest, make it vulnerable to compression during movement (example: hip extension).
This nerve entrapment injury results in a condition called ‘meralgia paraesthetica’ that leads to impaired sensation, pain, and paresthesia to the anterolateral region of the thigh. Weight gains, pregnancy, diabetes, and wearing of tight belts or waisted clothes, all contribute in exacerbating the symptoms.
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