Maigne J Y, Maigne R, Guérin-Surville H
Surg Radiol Anat. 1986;8(4):251-6. doi: 10.1007/BF02425075.
On the supposition that some "pseudocoxalgias" might be due to a neuralgia of the lateral rami leaving the subcostal and iliohypogastric nerves above the lateral edge of the iliac crest, the authors undertook an anatomic study of their pathways and pattern of distribution. These rami supplying the skin below the iliac crest, which they cross close together, the ramus arising from the subcostal nerve by perforating the internal and external oblique abdominal muscles, that arising from the iliohypogastric nerve a little lower, creating a bony groove palpable in thin subjects and transformed into an osseomembranous tunnel by the aponeurosis of these muscles. This arrangement may give rise to an entrapment syndrome. At this intersection, the course is either vertical or "bayonet-shaped", directly subcutaneous, and hence exposed to possible friction and microtraumata (tight clothes). The two rami are of unequal length. Frequently, the ramus arising from the subcostal nerve is short, not exceeding 10 cm, below the iliac crest, thus corresponding to the usual description. That arising from the iliohypogastric nerve descends further, passing 3 to 5 cm anterior to the great trochanter. It ends either at this level or 8 to 10 cm below. This accounts for the distribution of the pain felt when there is irritation of this ramus.
基于某些“假性髋痛”可能是由于肋下神经和髂腹下神经在髂嵴外侧缘上方发出的外侧支神经痛所致的假设，作者对其走行和分布模式进行了解剖学研究。这些分支供应髂嵴下方的皮肤，它们相互靠近穿过，来自肋下神经的分支通过穿经腹内斜肌和腹外斜肌穿出，来自髂腹下神经的分支稍低一些穿出，在瘦人身上可摸到一个骨沟，这些肌肉的腱膜将其转变为一个骨膜性隧道。这种结构可能导致卡压综合征。在这个交叉点处，走行要么是垂直的，要么是“刺刀状”，直接位于皮下，因此容易受到摩擦和微创伤（紧身衣物）。这两个分支长度不等。通常，来自肋下神经的分支较短，在髂嵴下方不超过10厘米，符合通常的描述。来自髂腹下神经的分支向下走得更远，在大转子前方3至5厘米处经过。它在此水平或下方8至10厘米处终止。这就解释了该分支受到刺激时疼痛的分布情况。
