femoral nerve trunk pain
Introduction
Introduction to femoral neuralgia Femoral neuralgia is not uncommon in clinical practice, especially in middle-aged women. In addition to the sciatic nerve trunk, the lower extremity femoral nerve is the largest branch, originating from the lumbar 2, 3, 4 nerves, descending along the psoas muscle and the iliopsoas muscle, and entering the femoral triangle (located on the lateral side of the femoral artery) from below the inguinal ligament. Separate the sense branch and the exercise branch. 1. Sensory branch: There are two branches: (1) anterior cutaneous nerve: 2/3 anterior medial skin distributed under the thigh. (2) saphenous nerve: distributed in the knee, calf and inner skin of the foot. 2. Exercise branch: mainly dominates the iliopsoas (issued in the pelvic cavity), sartorius muscle, pubic muscle and quadriceps. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: swelling
Cause
Cause of femoral nerve dry pain
(1) Causes of the disease
Damage caused by various reasons, caused by indentation or other pathological changes.
(two) pathogenesis
1. Pelvic disease: In addition to tumors, especially in gynecological diseases, followed by lumbar muscle and retroperitoneal inflammation.
2. Spinal lesions: more common in the 3 to 4 lumbar disc herniation (de-), tuberculosis, fracture, degeneration or spinal canal lesions.
3. Neuritis: It is common to be multiple, and it is easy to appear in cases of infection, poisoning or diabetes.
Prevention
Femoral neural dry pain prevention
In peripheral neuropathy, it is important to maintain functional activity in the painful area, which is beneficial for preventing nutritional changes, disuse atrophy and joint stiffness. Psychological factors are often taken into account from the very beginning of treatment. If you have anxiety and depression, you should be treated appropriately. If the dysfunction persists, the comprehensive treatment of the pain treatment center may be helpful to the patient.
Complication
Complications of femoral neuralgia Complications swelling
The functions of the nerves are: nutrition, conduction, support and other functions. The complications of this disease are mainly caused by demyelination of nerve fibers, even the disintegration of distal axonal and Waller degeneration of myelin. During limb movement, nerve fibers in the stenotic channel undergo chronic inflammatory inflammation under mechanical stimulation and aggravate the vicious circle of edema-ischemia. This further causes damage, so patients with this disease should actively treat to prevent complications.
Symptom
Symptoms of femoral nerve dry pain Common symptoms Shallow sensation loss or loss of sensory sensation Back pain gluteal muscle atrophy Lower abdominal tenderness Lumbar spine pain
1. Abnormal feeling: abnormalities such as hyperesthesia, tingling and feeling loss may occur in the front and inner side of the thigh and calf.
2. Pain and tenderness: The pain starts in the groin and radiates downward to the inside of the thigh, even to the far side of the calf, and there is significant tenderness at the midpoint of the groin (outside of the femoral artery) and radiates downward.
3. Muscular atrophy: The quadriceps are most obvious. When measuring the circumference of the bilateral thighs, the affected side may be reduced by 1~2cm and affect the knee extension function.
4. Reflection: The knee reflex is weaker than the healthy side (early can be active) or even disappears.
Examine
Examination of femoral neuralgia
X-ray examination can exclude lumbar bone lesions and disc herniation, as well as pelvic space-occupying lesions.
Diagnosis
Diagnosis and diagnosis of femoral neural dry pain
1. General diagnosis
According to the above characteristics, there is generally no difficulty.
2. Cause diagnosis
(1) due to the cause of the spine or spinal canal: more with low back pain, paravertebral tenderness and cramps, positive neck test, limited lumbar motion and other symptoms.
(2) due to pelvic diseases: more dry symptoms (or plexus symptoms), can be diagnosed by anal or double diagnosis of pelvic conditions; when the horse is positive, it indicates that the inflammation of the waist may be greater The film should be removed after the enema is cleaned as appropriate to exclude tumors.
(3) due to the compression of the femoral nerve trunk itself: mainly manifested as a single femoral nerve dry symptoms, negative lumbar signs, no pelvic symptoms, closed therapy is effective.
Differential diagnosis
1. Hip disease: including early stage of suppurative inflammation, tuberculosis, aseptic necrosis of the femoral head, except for systemic symptoms and positive signs of hip joints, X-ray films are often abnormal.
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3. Inguinal lymphadenitis: can also affect the femoral nerve, but its signs are obvious, can be touched with tender lymph nodes, etc., easy to identify.
