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Clin Neurophysiol. 2014 Jun;125(6):1278-84. doi: 10.1016/j.clinph.2013.10.053. Epub 2013 Dec 7.

Contribution of ultrasound in the assessment of patients with suspect idiopathic pudendal nerve disease.

Author information

1
Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Via de Toni 14, 16132 Genoa, Italy. Electronic address: albertotagliafico@gmail.com.
2
Radiology Department, DISSAL, Università di Genova, Largo Rosanna Benzi 8, 16138 Genoa, Italy.
3
Unit of Human Anatomy and Embryology, Department of Pathology and Experimental Therapy, Faculty of Medicine (C Bellvitge), University of Barcelona, Barcelona, Spain.
4
Neurology Department, AOU San Martino-IST, Largo Rosanna Benzi 8, 16138 Genoa, Italy.
5
Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Austria.

Abstract

OBJECTIVE:

To assess if Ultrasound (US) is contributive in patients suspected of having idiopathic pudendal neuralgia.

METHODS:

Between July 2012 and April 2013, 10 consecutive female patients with suspected idiopathic pudendal neuralgia (mean age: 47±14 years; mean BMI: 24±3) were included. Two radiologists blinded to the clinical and neurophysiological data performed pudendal nerve evaluation with broadband linear array transducers (12-7 MHZ, and 17-5 MHZ). MRI was added to confirm US data. A third independent clinician, who did not perform electrodiagnosis and US, reviewed the data and scored US as "contributive" or "non-contributive": if US confirmed the clinical and neurophysiological diagnosis or if US findings were not useful.

RESULTS:

Ultrasound identified alterations to the pudendal nerve in 7/10 of cases (70%). In seven cases US revealed the presence of a diffusely or focally enlarged pudendal nerve confirmed by MRI. In these cases neurophysiological findings were suspicious for pudendal neuralgia in 5/7 cases, whereas in 2/7 cases they were inconclusive.

CONCLUSION:

High-resolution ultrasound (US) may demonstrate alterations to the pudendal nerve in patients with pudendal neuralgia.

SIGNIFICANCE:

US is useful in patients with suspected idiopathic pudendal nerve disease.

KEYWORDS:

Anatomy; Entrapment; Magnetic resonance imaging; Pathology; Perineal nerves; Pudendal nerve; Ultrasound

Comment in

PMID:
24368033
DOI:
10.1016/j.clinph.2013.10.053
[Indexed for MEDLINE]

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