ilioinguinal nerve originates from the T12 and L1 nerve roots
sensory area supplied
pubic symphysis and the superomedial aspect of the femoral triangle receive a sensory supply from this nerve
ilioinguinal nerve entrapment syndrome is an abdominal muscular pain syndrome, characterized by the clinical triad of muscular type iliac fossa pain with a characteristic radiation pattern, an altered sensory perception in the ilioinguinal nerve cutaneous innervation area, and a well-circumscribed trigger point medial and below the anterosuperior iliac spine. Relief of pain by infiltration of a local anaesthetic confirms the diagnosis
ilioinguinal nerve can be injured during surgical approaches to the lower abdomen, during pregnancy and bone graft harvesting from the iliac region
nerve entrapment can occur at the point where it passes through the transversus abdominis and internal oblique muscles medial to the anterosuperior iliac spine (ASIS)
nerve injury can also occur with tearing of the lower external oblique aponeurosis
diagnosis of nerve injury is made clinically
neuropathy of the ilioinguinal nerve has three characteristics; pain, altered sensation and the presence of a trigger point
pain
occurs in the iliac fossa and radiates to the groin, scrotum or labia majora, the proximal medial aspect of the thigh and the back
altered sensation may be hyper-,hyo- or dysaesthesia
trigger point is present medial and distal to the ASIS
patient walks with a flexed trunk gait
provocative testing involves hip extension
also palpation of the inguinal canal or medial to the ASIS may reproduce these symptoms
local aesthetic injection can aid diagnosis as it is difficult to differentiate the pain caused by the iliohypogastric, ilioinguinal and genitofemoral nerves due to the overlap of sensory innervation
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