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Pectineo-femoral pinch syndrome: A common cause of leg groin testicular/labial neuralgias

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MSK Neurology

Groin and anterior femoral pain is relatively common, especially amongst women, and can sometimes be debilitating. These symptoms are often wrongfully diagnosed as generalized diagnoses such as pelvic girdle syndrome, or as fibromyalgia. It can also be misdiagnosed as meralgia paresthetica, femoral or saphenous neuralgias. This article will detail an unknown but common musculoskeletal pathology that I have called pectineofemoral pinch syndrome (PFPS), which often causes these exact symptoms. To the best of my knowledge, this condition has not been mentioned in the literature until our study (Larsen & Chieng 2019) included it briefly as a subcomponent of lumbosacral plexus entrapment syndrome, in 2019.

Pectineofemoral pinch syndrome is a condition where the nerve bundle emerging from the femoral triangle (femoral, lateral femoral cutaneous, genitofemoral and ilioinguinal nerves), as well as the obturator nerves become positionally compressed by a combination of very tight upper adductor complexes (pectineus, add. brevis, add. longus), resulting in what often seems to be lumbar plexopathic pain due to its large potential area of affection, but is really caused by compression of the bundle of nerves in its periphery rather than at the site of the plexus. This holds especially true for patients where the symptoms are exclusively positional, ie., occurring during or after provocative hip flexion.

posted by Criewenzu