Ultrasound-Guided Injection in Meralgia Paresthetica: A Case Series and Technical Report

This case series describes high-resolution ultrasound-based diagnosis of meralgia paresthetica and the technical details of ultrasound-guided perineural therapeutic steroid injections. Twelve patients with clinically suspected meralgia paresthetica were prospectively assessed. The cross-sectional area of the lateral femoral cutaneous nerve was measured proximal and distal to the inguinal ligament using an 18-MHz transducer. Of the 12 patients, 10 demonstrated sonographic abnormalities, with a cross-sectional area difference greater than 2 mm2 serving as a diagnostic criterion. Eight patients with confirmed diagnosis and nonsurgical causes of entrapment underwent ultrasound-guided perineural triamcinolone acetate injections, resulting in complete symptom relief in 87% of cases at 6 weeks. Literature review findings showed comparable success rates of 80 to 85% for ultrasound-guided injections and 80% for surgical decompression. No significant complications were encountered, highlighting the safety and efficacy of this minimally invasive approach. High-resolution ultrasound thus serves as a valuable tool for both diagnosis and guided treatment of meralgia paresthetica, offering cost-effective and patient-friendly management with outcomes comparable to surgery.