MRI Results & Canada doctor

[cwb125]

Seems my MRI confirms pudendal nerve entrapment. Already on pregabalin 300mg per day with a little help originally but flare up just happened and its unbelievable pain that ER thought I had testicular torsion as I had left testicular pain and swelling. Give me some Percocet till I can get back to my doctor. Going on day 5 of the flare up and want to breakdown and cry. Any recommendations on what to try next for meds? Or do I ask the doctor for meds for flare ups?

Been referred to a Scrotal Pain Clinic and Urology at Mt Sinai with Dr. Keith Jarvi, but have to wait till June 2024 for that.

Any recommendations for a doctor in Canada for males for pudendal nerve entrapment? Just want to ensure I'm heading the right direction to get some relief.

Thanks for any help given.

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CLINICAL INDICATION: Intermittent left testicular and proximal thigh pain/numbness. Worsens with sitting/bicycle seats. Concern for predental neuropathy, please rule out any nerve abnormalities (if visible) or space-occupying lesions.

TECHNIQUE: Multiplanar, multisequence MR images through the lumbar plexus were obtained.

FINDINGS:
On the axial T1, there is a prominent vascular loop around the left pudendal nerve. There is asymmetric thickening of the left sacrospinous/sacrotuberous ligaments and adjacent sacrococcygeal muscle. There is a thickened left pudendal neurovascular bundle posterior to the sacrospinous/sacrotuberous ligaments with additional thickening within Alcock's canal.
On the T2 axial SPAIR sequence, there is corresponding hyperintensity of the left pudendal nerve which may represent mechanical irritation/impingement. There may be scarring in the leftsacrospinous/sacrotuberous ligament area.
Muscle bulk is maintained about the pelvis. Mild edema at the lateral greater trochanters may reflect trochanteric pain syndrome. Clinical correlation regarding tenderness in this region is suggested.
Iliopsoas and hamstrings tendons are intact. No significant joint effusions at the hips. Small amount of high T2 signal at the lateral aspect of the right labrum suggesting compatible with a nondisplaced labral tear with a small amount apparentlylabral cyst extending along the anterior inferior labrum/acetabulum.

OPINION:
1. The findings of a prominent vascular loop around the left pudendal nerve with asymmetric thickening of the left sacrospinous/sacrotuberous ligaments and adjacent sacrococcygeal muscle together with a thickened left pudendal neurovascularbundle suggests the possibility of pudendal nerve entrapment/mechanical irritation and possibly a degree of scarring.
2. Mild edema along the lateral greater trochanters may reflect trochanteric pain syndrome. Correlation to the site of patient's tenderness is suggested.
3. Nondisplaced tear of the right superior labrum with small paralabral cyst.

What kind of MRI did you have done?

[twistedto]

Lumbosacral Plexus MRI

[cwb125]

Thanks. Does anyone know if that is different than a "MRI Neurography Pelvis?"

[twistedto]

Don’t quote me on this, this is ChatGPT reply:

Lumbosacral plexus MRI focuses on imaging the entire lumbosacral plexus, including the nerves extending from the lower back through the pelvis.

Neurography pelvic MRI, on the other hand, specifically targets the nerves within the pelvis.

So, while both techniques involve imaging nerves, lumbosacral plexus MRI covers a broader area, while neurography pelvic MRI is more focused on the nerves within the pelvic region.

[cwb125]

Thanks for that. Well, I am glad the imagine worked for one of us!