Health Organization for Pudendal Education

I was diagnosed with severe enthesitis of gluteus min and med,(from my 1T MRN scan) which I was then told was an inflammation of the entheses ,where the muscle originates and terminates next to the bone. I have presumed that ischeal tuberosity pain was related to that, as it is at the end part of bone. I know that if I rub my illiac crest I also get pain so it made sense.
I have just discovered that neither of those muscles end or start there, so that explanation can't be right. . . .However of course the sacrotuberous ligaments do and enthesitis can affect ligaments http://en.wikipedia.org/wiki/Enthesitis and can be related to 'recurring stress' I don't know how a diagnosis of ligament enthesitis is reached (can it be seen on MRI??) but I guess that could be one answer to ischeal tuberosity pain, although admittedly I have never even heard enthesitis mentioned in any report apart from mine,so this could be completely wrong. Just throwing it into the mix.

Interesting Helen. I have never heard of enthesitis. Sounds possible at least from the definition.

Interesting Helen. I have never heard of enthesitis. Sounds possible at least from the definition.

Kathy, similar to an MRI, an MRN may or may not show an entrapment. An MRN is essentially an MRI using special software/settings. If something shows up on the MRI or MRN it can be helpful but unfortunately, these tests are not proven to be 100% accurate in the diagnosis.

I'm sorry the embolization didn't help. What other diagnostic tests have you had besides the MRI? Have you been evaluated by a PT who specializes in pudendal neuralgia yet?

My pain prior to surgery was always a deep, toothache-like pain which eventually progressed to knife-like pain near the alcock's and ischial spine area. This was located via internal examination by a PT who was knowledgeable about PNE. Also felt like I had been hit in the butt and crotch. So I can't say what's going on in your case, I can only tell you my pain was very similar to what you are describing and that the deep knife-like pain was one of the first things to improve after surgery.

Violet,
I just read this older post. The knife-like pain you describe is the exact pain I have had from day one, and it seems to be in the same location. In my op report, Dr Conway states the alcock's canal was clear. It says nothing about the falciform process. Did Dr. Beautrant open up your alcocks's canal? I have read that Dr. Ansell actually opens up the canal along the fascia. You state the knife-like pain was one of the first things to improve. I have had two surgeries, and the knife-like pain is screaming at me. How long do you mean by "one of the first things to improve?" Thanks, Paulette

Paulette, as I understand it, Dr. Bautrant doesn't completely open the alcock's canal but in my surgery he was able to shave off part of the falciform process of the ST ligament.

I had soreness at the ischial tuberosity but the knife-like pain was at the ischial spine where the ST and SS ligaments cross. I wish I could remember exactly how long it took for that knife-like pain to improve but I think it was within the first 3 months.