평영 이후 발생한 일측 대퇴신경병증
Unilateral Femoral Neuropathy after Swimming with Breaststroke
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Femoral nerve arises from the ventral rami of the second, third and fourth lumbar nerves and runs beneath the inguinal ligament, into the thigh. The nerve can be compressed anywhere along its course, but it is particularly susceptible at the iliopsoas groove and at the inguinal ligament. We experienced a 52 years old female who had weakness in knee extension and hypoesthesia in medial aspect of thigh and calf after swimming with breaststroke for several hours a day in a week. The diagnosis was established with clinical findings, nerve conduction study and needle electromyography. The mechanism of neuropathy are direct compressive irritation of nerve within inguinal ligament by sharp hip flexion and excessive stretch on nerve due to hip abduction and external rotation during breaststroke. We should consider possibility of femoral neuropathy in patient with weakness in knee extension or hypoesthesia in medial thigh and calf after swimming with breaststroke and distinguish between radicular lesion and peripheral lesion by physical exam and electrodiagnostic study.
Abstract
Femoral nerve arises from the ventral rami of the second, third and fourth lumbar nerves and runs beneath the inguinal ligament, into the thigh. The nerve can be compressed anywhere along its course, but it is particularly susceptible at the iliopsoas groove and at the inguinal ligament. We experienced a 52 years old female who had weakness in knee extension and hypoesthesia in medial aspect of thigh and calf after swimming with breaststroke for several hours a day in a week. The diagnosis was established with clinical findings, nerve conduction study and needle electromyography. The mechanism of neuropathy are direct compressive irritation of nerve within inguinal ligament by sharp hip flexion and excessive stretch on nerve due to hip abduction and external rotation during breaststroke. We should consider possibility of femoral neuropathy in patient with weakness in knee extension or hypoesthesia in medial thigh and calf after swimming with breaststroke and distinguish between radicular lesion and peripheral lesion by physical exam and electrodiagnostic study.
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