Numbness and paresthesias along the anterolateral aspect of the right thigh likely indicate involvement of the lateral femoral cutaneous nerve (LFCN), a condition known as meralgia paresthetica. This nerve supplies sensation to the anterolateral thigh, and its compression or irritation can cause these symptoms.

Possible Causes:

1. Compression of the LFCN:
   • Tight clothing, belts, or obesity.
   • Prolonged sitting or standing.
   • Pelvic or abdominal masses (e.g., tumors, pregnancy).
2. Nerve Injury:
   • Trauma or surgery in the pelvic region.
   • Diabetes or other neuropathies.
3. Spinal or Central Causes (less likely):
   • Lumbar radiculopathy (L2-L3 nerve roots).
   • Spinal stenosis or disc herniation.
4. Systemic Conditions:
   • Hypothyroidism, alcoholism, or vitamin B12 deficiency.

Evaluation:

• History: Duration, triggers (e.g., tight clothing), associated symptoms (e.g., back pain, weakness).
• Physical Exam:
  • Sensory testing over the anterolateral thigh.
  • Tinel’s sign over the inguinal ligament (tingling with tapping).
  • Rule out motor weakness or reflex changes (suggests radiculopathy).
• Diagnostics (if needed):
  • Nerve conduction studies to confirm LFCN involvement.
  • Imaging (MRI/CT) if spinal or pelvic pathology is suspected.
  • Blood tests for diabetes, thyroid function, or B12 levels.

Management:

1. Conservative:
   • Avoid tight clothing or belts.
   • Weight loss if obesity is a factor.
   • Physical therapy for posture and core strength.
   • Medications: NSAIDs, gabapentin, or pregabalin for neuropathic pain.
2. Interventional:
   • Local corticosteroid injections for persistent symptoms.
   • Nerve block in refractory cases.
3. Surgical (rare):
   • Decompression of the LFCN if conservative measures fail.

When to Refer:

• Symptoms persist despite conservative treatment.
• Signs of motor weakness, reflex changes, or bowel/bladder dysfunction (suggests spinal pathology).
• Suspected mass or systemic disease.

Disclaimer: owerl is not a doctor; please consult one.