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Meralgia paresthetica: from qualitative ultrasound assessment to quantitative multimodality imaging Cover

Meralgia paresthetica: from qualitative ultrasound assessment to quantitative multimodality imaging

Journal of Ultrasonography
Volume 26 (2026): Issue 104 (April 2026)
By: ,  ,  ,  ,  ,   and    
Open Access
|Mar 2026
Figures & tables

Figures & Tables

Fig. 1.

Anatomic variants of the anterolateral femoral cutaneous nerve according to the classification proposed by Aszmann et al.(4) The nerve may course: A. posterior to the anterior superior iliac spine (ASIS) (4%); B. through the iliac ligament (IL) (27%); C. within the tendinous origin of the sartorius muscle (23%); D. between the iliopsoas and the sartorius tendinous origin (26%); or E. within the connective tissue over the iliopsoas muscle without contacting the IL, occasionally giving fibers to the femoral branch of the genitofemoral nerve (20%)

Fig. 2.

Transverse US images of the inguinal–femoral region showing the course and bifurcation of the anterolateral femoral cutaneous nerve. A. The nerve is identified (arrow) in a more proximal plane, prior to its bifurcation, located superficially within the subcutaneous tissue and just above the deep fascia. B. At a slightly more distal level, the nerve bifurcates into two terminal branches (arrows), which remain within the subcutaneous tissue and course over the deep fascia covering the sartorius muscle (asterisk). C. In a further distal plane, the two branches (arrows) appear more widely separated as they continue along their superficial course

Fig. 3.

Short-axis high-resolution US image (A) of the lateral femoral cutaneous nerve showing marked focal enlargement with increased cross-sectional area (3.4 mm2) and hypoechoic fascicular swelling, consistent with neuropathic thickening at a typical site of entrapment near the inguinal region. Loss of the normal crisp fascicular definition supports the presence of structural nerve alteration. Long-axis view (B) of the LFCN demonstrating segmental enlargement and decreased fascicular echogenicity

Fig. 4.

Short- and long-axis (A, B) shear-wave elastography of the symptomatic side shows focal nerve enlargement and a higher stiffness profile, with shear-wave values reaching 53.0 kPa, compared with 36.8 kPa on the asymptomatic side. The affected nerve also exhibits a slightly increased maximum diameter (0.30 mm vs 0.24 mm), together with subtle blurring of the internal fascicular pattern. Corresponding contralateral images (C, D) demonstrate lower elasticity values and a more regular fascicular appearance, serving as an internal reference. The side-to-side differences in diameter and stiffness reflect early structural and mechanical alterations encountered in meralgia paresthetica

Fig. 5.

Axial STIR image (A) at the proximal thigh demonstrating the bifurcation of the anterolateral femoral cutaneous nerve on the symptomatic side (arrows). The nerve appears mildly enlarged with increased fluid-sensitive signal, consistent with early neuropathic involvement along its intra-thigh course. Fractional anisotropy map (B) combined with diffusion-tensor tractography (C). The region of interest (arrow), positioned approximately 4 cm caudal to the inguinal ligament and coregistered with the corresponding axial T2-weighted image, shows a marked FA reduction on the affected side (0.33 vs 0.61) accompanied by a less compact and more dispersed fiber trajectory. These findings indicate localized microstructural disruption of the nerve

Fig. 6.

Ultrasound-guided perineural injection of the anterolateral femoral cutaneous nerve. Arrowheads indicate the in-plane trajectory of the advancing needle, directed toward the perineural fat plane adjacent to the nerve (asterisk). Proper needle positioning allows safe deposition of the injectate around the nerve while avoiding nearby vascular and fascial structures
DOI: https://doi.org/10.15557/jou.2026.0010 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
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Language: English
Submitted on: Nov 24, 2025
Accepted on: Feb 23, 2026
Published on: Mar 31, 2026
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
ultrasound,
sonography,
lateral femoral cutaneous nerve,
nerve imaging,
meralgia paresthetica
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2026 Vito Chianca, Edoardo Cesaro, Marco Curti, Nicola Landi, Antonio Fontanarosa, Marcello Zappia, Filippo Del Grande, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 26 (2026): Issue 104 (April 2026)
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