Ann Rehabil Med.  2012 Apr;36(2):273-277. 10.5535/arm.2012.36.2.273.

Femoral Neuropathy and Meralgia Paresthetica Secondary to an Iliacus Hematoma

• Yi TI
• Yoon TH
• Kim JS
• Lee GE
• Kim BR

• KMID: 2266768
• DOI: http://doi.org/10.5535/arm.2012.36.2.273

Abstract

Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9x5x4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.

Keyword

Femoral neuropathy; Meralgia paresthetica; Iliacus hematoma

MeSH Terms

Adolescent
Decompression, Surgical
Electromyography
Femoral Neuropathy
Follow-Up Studies
Hematoma
Humans
Hypesthesia
Leg
Needles
Nerve Compression Syndromes
Neural Conduction
Pelvic Bones
Regeneration
Thigh
Nerve Compression Syndromes

Figure

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  Fig. 1 Circumferences measured 10 cm above the superior patellar border show notable difference. The right side is 40 cm, while the left is 46 cm (frontal view) (A). The dotted area is the area of hypesthesia (lateral and medial view) (B).

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  Fig. 2 Enhanced coronal (A) and transverse (B) T2-weighted pelvis MRI show an area of high signal intensity in the right iliacus muscle, consistent with hematoma (arrow).

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