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Dec
08

Differential

I have been tweeting a bit about my recent journey into patient-hood. And I admit to being a bit stumped about this one…

About a month ago, I started noticing some discomfort on my left lateral thigh. I guess you could describe it as neuropathic pain, but it wasn’t necessarily painful. It only occurred with light touch, and was exacerbated by raising my leg or externally rotating my hip. Weird. I remember something similar happening a couple years ago and it only lasted for a few days. So I shook it off and continued with my daily routines. I exercised and was pleased that it only bothered me with certain movements. Like lunges – and who doesn’t hate lunges anyway? I was determined not to let this annoyance interfere with my life.

But alas…I’m dismayed to report that the discomfort has officially become pain. And it becomes worse each day. And the more I’m on my feet, the worse it gets. Which means it’s excruciating by the end of the workday. It’s interrupted my exercise schedule and caused me to wuss out and ride the elevator on more than one occasion.

So being a nurse/geek, I did a literature search on myself. I came up with bupkus at first, until I finally came across a condition known as meralgia paresthetica. It’s a superficial pain on the lateral surface of the upper leg, caused by compression of the lateral femoral cutaneous nerve. The symptoms fit perfectly.

In the meantime, my hubby told me enough was enough and ordered me to see a professional who was actually licensed to diagnose me. I went on Monday and the NP I saw was equally stumped. We ran through a differential diagnosis together. Shingles? No, a rash would have presented by now. Sciatica? The pain didn’t seem to radiate far enough down my leg and it was unusual that the pain was exacerbated by contact. DVT? No heat, redness or swelling (and an unusual location for a DVT to boot). But when she palpated my left lumbar region, I wanted to curl up into a fetal position and cry from the excruciating pain. Which was new. She took the literature I brought about meralgia paresthetica (of course I brought it with me!) and sent me down to x-ray.

Results today: normal, save for a slight curvature of my spine to the left. Intervertebral spaces seem fine.

The plan at this point is a follow-up appointment on Friday with an osteopath and an MRI when my prior authorization gets approved. And a week of prednisone. Which has already turned me into a jittery, starving mess.

So I turn to you, dear readers. Have you ever seen this (or experienced it yourself)? Any clues? Diagnostic guesses? Treatment suggestions?

I would love to get my life back.

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