Case Presentation - Radiating Leg Pain in an Obese Patient

The patient was diagnosed with meralgia paresthetica (MP), compression of the lateral femoral cutaneous nerve beneath the inguinal ligament which supplies sensation to superficial skin of thigh. There are no motor symptoms because the lateral femoral cutaneous nerve is a purely sensory nerve. 

Dyesthesias are common; all other PE findings are typically normal. Iliotibial band syndrome typically presents with knee pain exacerbated by cycling or running downhill and tenderness to palpation of the lateral femoral epicondyle. Patients with greater trochanteric bursitis complain of pain frequently made worse when lying on the affected side. Lumbar disk herniation with radiculopathy typically presents with back pain that radiates down the posterior and occasionally lateral thigh. 

Acknowledging that the incidence of MP is expected to increase as the prevalence of obesity and diabetes increase, it is important to recognize signs and symptoms early. Counseling may be warranted for patients who have diabetes or are obese.