Alberto Tagliafico1, Bianca Bignotti2, Maribel Miguel Perez3, Lizia Reni4, Gerd Bodner5, Carlo Martinoli2. 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.
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.