can anyone help decipher this mri reading/what doc to see

Discussion of magnetic resonance imaging and magnetic resonance neurography
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PNSucks
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Joined: Tue Feb 28, 2012 8:19 pm

can anyone help decipher this mri reading/what doc to see

Post by PNSucks »

There us anterior angulation of the coccyx, which is minimally deviated to the right. The anococcygeal ligament appear symmetric as is the coccygeous muscle. The sacrospinous and sacrotuberous ligaments appear symmetric and there is no scar entrapment of the pudendal nerves adjacent to the ligaments. Hamstring tendinosis is seen without ischial bursitis. The pudendal nerves in the posterior margin of Alcock’s canal appear unremarkable. There is scar on the left surrounding the superficial perineal muscles at the vestibule, extending to the lateral side wall of the Alcock’s canal and abutting some of the anterior inferior perineal branches of the pudendal nerves that extend to the anterior margin of the anus. This is noted on series 6, images 17 through 21. This is also present but to a much lesser extent on the right. The posterior inferior perineal branches appear unremarkable. The levator ani muscles appear symmetric. The obturator internus muscles also appear unremarkable. There is some resorption of the inferior margin of the pubic symphysis, with a projection of bone off the posterior margin of the right pubis, seen on series 6 images 38 and 39, abutting small branch vessels but not directly abutting the dorsal nerve to the clitoris. Dorsal nerves to the clitoris appear fairly symmetric. No pelvic adenopathy is seen. There is some prominence of the pericervical venous plexus but without features to suggest marked pelvic venous congestion syndrome. Varices do extend into the anteroinferior margin of Alcock’s canal, more prominent on the right than the left.

There is no occult fracture or osteonecrosis. There is thickening of the greater trochanteric bursae but no bulky bursitis. Images obtained anteriorly demonstrate no appreciable scarring around the genital branches of the genitofemoral or the ilioinguinal nerves.

No regional adenopathy is seen. Small foci of diminished signal intensity are seen in the uterus compatible with small degenerative leiomyomata.

Impression
MRI of the pelvis demonstrates scarring of the pelvic floor localized around the superficial perineal muscles, extending to the left lateral margin of Alcock's canal adjacent to the pudendal nerve, as well as around the anterior inferior perineal branches to the anus. There are slightly prominent veins in the Alcock's canal inferiorly without evidence of extensive pelvic venous congestion syndrome. The nerves more posteriorly adjacent to the sacrotuberous ligaments appear unremarkable.
Lernica
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Joined: Fri Jan 14, 2011 10:31 pm

Re: can anyone help decipher this mri reading/what doc to se

Post by Lernica »

Dear PNSucks,

Welcome to HOPE. Your MRI report indicates that Potter doesn't think you have pudendal neuralgia. Who diagnosed you with PN? Have you had physiotherapy with a pelvic pain specialist? Maybe the source of your pain is muscular, a.k.a. pelvic floor myalgia? Do not despair; not having PN is a good thing!! It means that you may obtain relief with less invasive methods than surgery. Please continue to peruse this website for more information and ideas on how to tackle your pelvic pain. You will find something that works for you.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
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Violet M
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Re: can anyone help decipher this mri reading/what doc to se

Post by Violet M »

I don't know, I'm not a doctor but maybe it would be a good idea to seek further clarification from Dr. Potter. I have a friend who had similar language about "scarring" in her Potter MRI report and when she asked Dr. Potter for clarification was told that "yes" she was entrapped.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
carolynm
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Joined: Fri Jul 22, 2011 4:25 am
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Re: can anyone help decipher this mri reading/what doc to se

Post by carolynm »

I would say your nerve is entrapped in scar tissue at Alcock's and the perineal branch.

c
PN after using pickaxe doing yardwork 6/11
Potter MRI: Scar tissue abutting L pudendal.
Hibner consult 10/11 w/ plan: 2 mo. PT
No meds work for me
PRF X 3 times in Denver ( was pain free for 5 months after second)
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