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

Abstract

ObjectiveTo assess if Ultrasound (US) is contributive in patients suspected of having idiopathic pudendal neuralgia. MethodsBetween July 2012 and April 2013, 10 consecutive female patients with suspected idiopathic pudendal neuralgia (mean age: 47±14years; mean BMI: 24±3) were included. Two radiologists blinded to the clinical and neurophysiological data performed pudendal nerve evaluation with broadband linear array transducers (12–7MHZ, and 17–5MHZ). 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. ResultsUltrasound 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. ConclusionHigh-resolution ultrasound (US) may demonstrate alterations to the pudendal nerve in patients with pudendal neuralgia. SignificanceUS is useful in patients with suspected idiopathic pudendal nerve disease.