Pain in outer thigh joint

Thigh pain is a common symptom, and there are many reasons for it. For example, standing for a long time during the day and excessive fatigue may cause thigh pain, lumbar disc herniation may also cause thigh pain, and lumbar muscle strain is also a cause of thigh pain. The location of thigh pain caused by different reasons is also different. So what causes pain in the outer thigh joint? Next, let’s take a closer look.

Lateral femoral cutaneous neuritis: The lateral femoral cutaneous nerve is derived from the 2nd to 3rd lumbar nerves, passes through the lateral edge of the psoas major muscle, obliquely passes through the iliacus muscle, along the pelvis through the deep surface of the inguinal ligament, and passes through the fascia lata 10 cm below the anterior superior iliac spine to the skin of the thigh. This disease may occur if the lateral femoral cutaneous nerve is affected by compression, trauma or infection during its course. Such as spinal deformity, hypertrophic spondylitis, spina bifida, lumbar spondylosis, intervertebral disc herniation, lumbar myositis, pelvic inflammatory disease, neurosyphilis, appendicitis, pregnancy, heavy labor, pelvic tumors, alcohol poisoning, inguinal hernia and sequelae of herpes zoster, etc., can induce this disease. Cold and humidity are also common causes of this disease.

Lateral femoral cutaneous nerve entrapment syndrome:

1. The lateral femoral cutaneous nerve is angled where it exits the pelvis and enters the thigh. In addition, due to anatomical variations, when the limbs are moved or the body position is improper, the nerve is subjected to continuous traction, friction, and compression, etc., causing local tissue edema, scar formation, and thickening of the muscle fascia sheath, resulting in nerve compression.

2. Pelvic fractures, tumors, foreign bodies, and plaster compress the lateral femoral cutaneous nerve, causing entrapment.

3. The nerves are stimulated when the iliac bone is removed during surgery, or local scar adhesions compress the nerves.

4. This syndrome may be caused by hematoma in the iliopsoas fascia caused by trauma or in patients with hemophilia.

Lateral femoral cutaneous neuritis: This disease is more common in obese men aged 20 to 50, and is also seen in pregnant women and working people. The main symptom is skin sensory disturbance in the anterior and lateral thigh (especially the lower 2/3 of the lateral thigh). Symptoms include numbness, tingling, burning sensation, chills, decreased sweating and a feeling of heaviness, but numbness is the most common and is often the first symptom. Symptoms may worsen after physical labor, standing or walking for too long, and may ease after rest. Objective examination may reveal varying degrees of decreased or absent superficial sensation, mainly decreased or absent pain, warmth, and touch sensations, while pressure sensation persists. The skin color in this area is normal, the skin may be slightly thin, slightly dry, and the vellus hair is reduced, but there is no muscle atrophy or movement disorder. The disease is usually unilateral, but rarely bilateral. The histamine test and pilocarpine sweat test of the affected area were normal.

The disease course is chronic, with symptoms that vary in severity and often last from months to many years.

Lateral femoral cutaneous nerve entrapment syndrome: Patients complain of numbness in the anterolateral thigh, tingling or burning pain, which worsens when walking and is relieved by bed rest. There is tenderness in the inner and inferior part of the anterior superior iliac spine, where the Tinels sign is positive, and the anterior and lateral thigh has decreased sensation or hyperesthesia. Symptoms worsen when the hip is extended and the lateral femoral cutaneous nerve is stretched.

In order to confirm the diagnosis and understand the cause of the pressure, further X-ray examination should be performed to check for bone lesions in the lumbar spine, pelvis and hip, or other diagnostic techniques should be used to rule out tumors, tuberculosis, inflammation or hemophilia.

The diagnosis can be established based on the medical history, clinical manifestations of local tenderness, positive Tinels sign, and worsening symptoms when the hip is extended.