Femoral Neuropathy

(Left) Coronal graphic shows the normal course of the femoral nerve image relative to the psoas muscle image and inguinal ligament image. The femoral nerve produces multiple peripheral branches to the anterior thigh muscles.

image
(Right) Coronal STIR MR (femoral neuropathy postsurgical herniorrhaphy) depicts marked enlargement, T2 hyperintensity of the right femoral nerve image, with abrupt transition at the right groin. In this case, the femoral nerve was accidentally ligated during herniorrhaphy.
image
(Left) Axial STIR MR (femoral neuropathy postsurgical herniorrhaphy) through the pelvis confirms that the right femoral nerve image in the iliopsoas groove is markedly enlarged with discrete T2 hyperintense fascicles (compared to the normal left femoral nerve image).

image
(Right) Axial CECT (severe hemophilia) depicts large left iliacus image and psoas image hematomas. Femoral neuropathy occurs from compression of the adjacent femoral nerve, which runs along the psoas muscle and iliopsoas groove.

TERMINOLOGY

Synonyms

• Femoral mononeuropathy, femoral nerve (FN) palsy

Definitions

• FN entrapment or injury 2° to direct trauma, compression, stretch injury, or ischemia

IMAGING

General Features

• Best diagnostic clue
image Femoral nerve enlargement, abnormal T2 hyperintensity
• Location
image Injury most common at psoas muscle body, iliopsoas groove, or femoral canal
• Morphology
image Nerve enlargement ± loss of internal fascicular architecture, abnormal T2 hyperintensity

CT Findings

• CECT
image ± retroperitoneal/psoas mass, hematoma, lymphadenopathy

MR Findings

• T1WI
image Isointense → hypointense nerve enlargement ± retroperitoneal/psoas mass
image ± hyperintense quadriceps muscle (fatty atrophy 2° to chronic denervation)
• T2WI
image Hyperintense nerve (± fascicular) enlargement
image ± abnormal quadriceps muscle T2 hyperintensity (acute/ongoing denervation)
• STIR
image Similar to fat-saturated T2WI
• T1WI C+
image ± enhancement (if neoplastic/inflammatory)

Only gold members can continue reading. Log In or Register to continue

Related posts:

Default ThumbnailOF THE CAUDAL CELL MESS Default ThumbnailMASSES AND TUMOR MIMICS Spread of Neoplasms Chiari 0 Anterior Lumbar Radiculopathy Traumatic Arteriovenous Fistula

Stay updated, free articles. Join our Telegram channel
Tags:
Oct 5, 2016 | Posted by in NEUROLOGICAL IMAGING | Comments Off on Femoral Neuropathy

Full access? Get Clinical Tree
Get Clinical Tree app for offline access