Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Diagnostic Approach to Lower Limbs Entrapment Neuropathies. A Narrative Literature Review

Version 1 : Received: 10 October 2023 / Approved: 10 October 2023 / Online: 11 October 2023 (14:31:58 CEST)

A peer-reviewed article of this Preprint also exists.

Drăghici, N.C.; Văcăraș, V.; Bolchis, R.; Bashimov, A.; Domnița, D.M.; Iluț, S.; Popa, L.L.; Lupescu, T.D.; Mureșanu, D.F. Diagnostic Approach to Lower Limb Entrapment Neuropathies: A Narrative Literature Review. Diagnostics 2023, 13, 3385. Drăghici, N.C.; Văcăraș, V.; Bolchis, R.; Bashimov, A.; Domnița, D.M.; Iluț, S.; Popa, L.L.; Lupescu, T.D.; Mureșanu, D.F. Diagnostic Approach to Lower Limb Entrapment Neuropathies: A Narrative Literature Review. Diagnostics 2023, 13, 3385.

Abstract

Entrapment neuropathies of the lower limb are a misunderstood and underdiagnosed group of disorders, characterized by pain and dysesthesia, muscular weakness, and specific provoking movements on physical examination. The most frequent of these syndromes encountered in clinical practice are fibular nerve entrapment, proximal tibial neuropathy, sural nerve neuropathy, deep gluteal syndrome or sciatic nerve entrapment and lateral femoral cutaneous nerve entrapment, also known as meralgia paresthetica. They are commonly mistaken for lumbar plexopathies, radiculopathies, and musculotendinous diseases, which appear even more frequently and have overlapping clinical presentations. A comprehensive anamnesis, physical examination, and electrodiagnostic studies should help clarify the diagnosis. If the diagnosis is still unclear or a secondary cause of entrapment is suspected, magnetic resonance neurography, MRI or ultrasonography should be conducted to clarify the etiology, rule out other diseases and confirm the diagnosis. Moreover, clinicians should gain familiarity with this disease and their diagnostic confidence should increase, leading to early diagnosis of nerve damage and prevention of muscle atrophy. The reviewed and updated epidemiology, anatomy, pathophysiology, etiology, clinical presentation and EDX technique and interpretation of the entrapment neuropathies of the lower limb are further described in this article.

Keywords

nerve compression syndromes; fibular neuropathies; tibial nerve; tibial neuropathy; sural nerve; hip socket neuropathy; deep gluteal syndrome; pseudosciatica; piriformis muscle syndrome; femoral neuropathy

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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