Skeletal Radiology

, Volume 42, Issue 6, pp 803–808

Meralgia paresthetica: 3-Tesla magnetic resonance neurography

  • Avneesh Chhabra
  • Filippo Del Grande
  • Theodoros Soldatos
  • Majid Chalian
  • Allan J. Belzberg
  • Eric H. Williams
  • Farahani S. Jalali
  • Gaurav K. Thawait
  • John Eng
  • John A. Carrino
Scientific Article

Abstract

Objective

To assess the diagnostic accuracy and observer performance of 3-Tesla magnetic resonance neurography (MRN) in the evaluation of meralgia paresthetica (MP).

Materials and methods

Two independent readers were blinded to the clinical diagnosis and evaluated the MRN studies of the pelvis of 11 patients with MP and 28 control participants. In each study, the lateral femoral cutaneous nerves were assessed for signal alteration and/or neuroma formation, indicating lateral femoral cutaneous neuropathy, at various levels along their course. Intra- and inter-observer reliability was evaluated.

Results

Both readers exhibited substantial intraobserver agreement in detecting signal alterations and neuroma formation of the lateral femoral cutaneous nerve (LFCN). The readers demonstrated moderate interobserver agreement in detecting signal alteration of the LFCN and poor interobserver agreement in diagnosing neuroma formation. Sensitivity, specificity, positive predictive value, and negative predictive value of LFCN neuropathy diagnosis were ≥71 % and ≥94 % for both readers respectively. The diagnostic test accuracy was ≥90 % for both readers.

Conclusion

3-Tesla MRN provides reliable and accurate diagnostic evaluation of meralgia paresthetica.

Keywords

Meralgia paresthetica Magnetic resonance neurography 3-Tesla 

References

  1. 1.
    Ivins GK. Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients. Ann Surg. 2000;232(2):281–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Patijn J, Mekhail N, Hayek S, Lataster A, van Kleef M, Van Zundert J. Meralgia paresthetica. Pain Pract. 2011;11(3):302–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Schestatsky P, Llado-Carbo E, Casanova-Molla J, Alvarez-Blanco S, Valls-Sole J. Small fibre function in patients with meralgia paresthetica. Pain. 2008;139(2):342–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Aravindakannan T, Wilder-Smith EP. High-resolution ultrasonography in the assessment of meralgia paresthetica. Muscle Nerve. 2012;45(3):434–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Tagliafico A, Padua L, Martinoli C. High-resolution ultrasonography in the assessment of meralgia paresthetica: some clarifications are needed. Muscle Nerve. 2012;45(6):922.PubMedCrossRefGoogle Scholar
  6. 6.
    Chhabra A, Chalian M, Soldatos T, Andreisek G, Faridian-Aragh N, Williams E, et al. 3-T high-resolution MR neurography of sciatic neuropathy. AJR Am J Roentgenol. 2012;198(4):W357–64.PubMedCrossRefGoogle Scholar
  7. 7.
    Zhang Z, Song L, Meng Q, Li Z, Pan B, Yang Z, et al. Morphological analysis in patients with sciatica: a magnetic resonance imaging study using three-dimensional high-resolution diffusion-weighted magnetic resonance neurography techniques. Spine (Phila Pa 1976). 2009;34(7):E245–50.CrossRefGoogle Scholar
  8. 8.
    Chhabra A, Faridian-Aragh N. High-resolution 3-T MR neurography of femoral neuropathy. AJR Am J Roentgenol. 2012;198(1):3–10.PubMedCrossRefGoogle Scholar
  9. 9.
    Suarez G, Sabin TD. Meralgia paresthetica and hypothyroidism. Ann Intern Med. 1990;112(2):149.PubMedCrossRefGoogle Scholar
  10. 10.
    Altman DG. Practical statistics for medical research. London: Chapman & Hall/CRC; 1991.Google Scholar
  11. 11.
    Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.PubMedCrossRefGoogle Scholar
  12. 12.
    Doklamyai P, Agthong S, Chentanez V, Huanmanop T, Amarase C, Surunchupakorn P, et al. Anatomy of the lateral femoral cutaneous nerve related to inguinal ligament, adjacent bony landmarks, and femoral artery. Clin Anat. 2008;21(8):769–74.PubMedCrossRefGoogle Scholar
  13. 13.
    Erbay H. Meralgia paresthetica in differential diagnosis of low-back pain. Clin J Pain. 2002;18(2):132–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Bernhardt M. Neuropathologische Beobachtungen. I. Periphere Lähmungen. D Arch Klin Med. 1878;22:362–93.Google Scholar
  15. 15.
    Grossman MG, Ducey SA, Nadler SS, Levy AS. Meralgia paresthetica: diagnosis and treatment. J Am Acad Orthop Surg. 2001;9(5):336–44.PubMedGoogle Scholar
  16. 16.
    Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology. 2011;77(16):1538–42.PubMedCrossRefGoogle Scholar
  17. 17.
    Beltran LS, Bencardino J, Ghazikhanian V, Beltran J. Entrapment neuropathies III: lower limb. Semin Musculoskelet Radiol. 2010;14(5):501–11.PubMedCrossRefGoogle Scholar
  18. 18.
    Sarala PK, Nishihara T, Oh SJ. Meralgia paresthetica: electrophysiologic study. Arch Phys Med Rehabil. 1979;60(1):30–1.PubMedGoogle Scholar
  19. 19.
    Seror P. Lateral femoral cutaneous nerve conduction v somatosensory evoked potentials for electrodiagnosis of meralgia paresthetica. Am J Phys Med Rehabil. 1999;78(4):313–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Baumer P, Dombert T, Staub F, Kaestel T, Bartsch AJ, Heiland S, et al. Ulnar neuropathy at the elbow: MR neurography–nerve T2 signal increase and caliber. Radiology. 2011;260(1):199–206.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2013

Authors and Affiliations

  • Avneesh Chhabra
    • 1
  • Filippo Del Grande
    • 1
  • Theodoros Soldatos
    • 1
  • Majid Chalian
    • 1
  • Allan J. Belzberg
    • 2
  • Eric H. Williams
    • 3
  • Farahani S. Jalali
    • 1
  • Gaurav K. Thawait
    • 1
  • John Eng
    • 1
  • John A. Carrino
    • 1
  1. 1.Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of NeurosurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of Plastic SurgeryJohns Hopkins Hospital and Dellon Institute for Peripheral Nerve SurgeryBaltimoreUSA

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