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The Hip Abduction Maneuver (HAM) to diagnose meralgia paraesthetica
Caio Pina1, Vincent Martinel2, Omar Fata Nahhas3
1Santa Casa de Misericórdia do Recife, Recife, Brazil. drcaio@caiopina.com.
Background:
Meralgia paresthetica (MP) is a compressive neuropathy of the lateral femoral cutaneous nerve (LFCN), characterized by pain, paresthesia, and numbness in the anterolateral thigh. Despite its well-documented etiology, diagnosing MP remains challenging, as complementary tests such as electromyography (EMG) and ultrasound may yield normal results due to anatomical variations and the dynamic nature of nerve compression.
Objective:
This study introduces the Hip Abduction Maneuver (HAM) as a novel diagnostic tool for LFCN compression and investigates its utility in clinical and intraoperative assessments METHOD: The maneuver, inspired by Hagert's triad, evaluates hip abduction weakness as a functional indicator of LFCN entrapment. MP can result from mechanical, metabolic, iatrogenic, traumatic, or anatomical factors. Compression occurs under the inguinal ligament, where orthogonal taping (OKT) can serve as a mechanical relief test to support diagnosis. HAM exploits afferent inhibitory responses, assessing hip abduction strength before and after decompression maneuvers. The Scratch Collapse Test (SCT) further improves diagnostic accuracy. The Hip Abduction Maneuver (HAM) and Orthogonal KinesioTaping (OKT) enhance the clinical assessment of meralgia paresthetica, particularly in cases with inconclusive imaging.
Conclusion:
Their integration into preoperative evaluation and intraoperative validation may improve diagnostic precision and optimize surgical outcomes. Further studies are required to validate reproducibility and long-term efficacy.
Insights
Diagnosing meralgia paresthetica (MP) is improved with the novel Hip Abduction Maneuver (HAM) and Orthogonal KinesioTaping (OKT). These methods aid in assessing lateral femoral cutaneous nerve (LFCN) compression, especially when imaging is inconclusive.
Area of Science:
- Neurology
- Orthopedics
- Diagnostic Medicine
Background:
- Meralgia paresthetica (MP) is a neuropathy of the lateral femoral cutaneous nerve (LFCN), causing thigh pain and numbness.
- Diagnosis can be difficult due to normal results from standard tests like EMG and ultrasound.
Purpose of the Study:
- Introduce the Hip Abduction Maneuver (HAM) as a new diagnostic tool for LFCN compression.
- Evaluate the utility of HAM and Orthogonal KinesioTaping (OKT) in clinical and intraoperative settings.
Main Methods:
- HAM assesses hip abduction weakness as a functional indicator of LFCN entrapment.
- Orthogonal KinesioTaping (OKT) acts as a mechanical relief test.
- The Scratch Collapse Test (SCT) is used to further enhance diagnostic accuracy.
Main Results:
- HAM and OKT improve the clinical assessment of meralgia paresthetica.
- These maneuvers are particularly useful in cases with inconclusive imaging results.
- The combination of HAM, OKT, and SCT enhances diagnostic precision for LFCN compression.
Conclusions:
- Integrating HAM and OKT into preoperative evaluation can optimize surgical outcomes.
- Further research is needed to confirm the reproducibility and long-term effectiveness of these diagnostic methods.
