Pain around the hip, groin or femoral area is one of the most common reasons on requests for ultrasound of the hip.
By understanding the position and course of the nerves of the hip and pelvis, pain in specific points may narrow the focus to assess specific nerves as the source.
This presentation will demonstrate the most common nerves that could be included in a hip and groin examination to provide greater correlation when assessing this area.
The presentation will include Lateral Femoral Cutaneous Nerve, Ilio-Iinguinal Nerve, Ilio-Hypogastric Nerve, Genito-Femoral Nerve- Genital and Femoral Branches, Femoral Nerve and other nerve groups in this area.
The discussion will include anatomical details and case presentations with the aim to develop a greater understanding to integrate assessment of these nerves in general scanning practices.

At the completion of this lecture, one should be familiar with the normal ultrasound appearance of a peripheral nerve, recognize the characteristic features of nerve entrapment, and be familiar with the common locations of nerve entrapment. As an introduction, peripheral nerves are most easily identified at ultrasound when imaged in short axis. This will ideally show the hypoechoic nerve fascicles surrounded by hyperechoic connective tissue producing a honeycomb appearance to a nerve trunk. The hallmark of nerve entrapment is edema and enlargement at and proximal to the site of nerve compression, typically where it enters into a fibro-osseous canal, where a transition to normal size is often seen. It is also important to evaluate the innervated muscle for ultrasound findings, as denervation edema, fatty infiltration, and fibrosis produces increased echogenicity. Decreased size of an involved muscle indicates atrophy. The most common site of nerve entrapment in the upper extremity is the carpal tunnel. The most accurate method to diagnose carpal tunnel syndrome using ultrasound is to identify median nerve enlargement of 2 mm2 or more at the carpal tunnel compared to more proximally at the pronator quadratus. Another median nerve entrapment, pronator teres syndrome at the elbow will also be discussed. Regarding the ulnar nerve, cubital tunnel syndrome will be reviewed including the use of dynamic imaging. Ulnar nerve abnormalities at the ulnar tunnel will also be reviewed. Last, radial nerve entrapment the supinator will be reviewed as seen with posterior interosseous nerve syndrome.