ultrasound of pudendal nerve

[Violet M]

http://www.ncbi.nlm.nih.gov/pubmed/23180573

Muscle Nerve. 2012 Jul 30. doi: 10.1002/mus.23537.
High-Resolution ultrasound of the pudendal nerve: Normal anatomy.
Tagliafico A, Perez MM, Martinoli C.


Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Largo Rosanna Benzi 8, 16132 Genoa, Italy. alberto.tagliafico@unige.it.
Abstract

Introduction: In this study we aimed to determine whether high-resolution ultrasound (US) can identify the pudendal nerve and its terminal branches. We also attempted to identify the best approach for visualizing these structures. Methods: Normal anatomy of the pudendal nerve was evaluated in 3 cadavers and 20 healthy volunteers proximally at the level of the ischial spine and distally with low-frequency (2-5-MHZ) and high-frequency (12-7-MHZ and 17-5-MHZ) transducers. Two musculoskeletal radiologists performed the examinations and evaluations. Volunteers were placed in 3 different positions, which allowed different approaches (posterior, medial, and anterior transperineal). A 0-3 scale was used to assess nerve visibility. Results: Visualization of the pudendal nerve at the ischial spine was best when using a medial approach (P < 0.004); the terminal branches were seen best with the anterior approach (P < 0.002). Conclusion: High-resolution ultrasound (US) can identify the pudendal nerve and its terminal branches. Muscle Nerve, 2012.

[helenlegs 11]

That is good news Violet. Thanks.
Would I be right in thinking that this visualisation will not be any good for diagnosis as nerve signal intensity will not be seen just the nerve itself? (which is great anyway)
Obviously any guided injections will be better placed when the whole nerve can be seen on ultrasound and any anatomical variations should not be a problem.

[Violet M]

My impression is that it's for visualizing the nerve rather than for diagnosis of pathology. I saw a recent report of a nerve block performed by Dr. Skaribis in Houston and he uses ultrasound, mentioning that he visualizes the nerve when he gives the nerve block. This sounds like the best type of nerve block if you ask me -- for accuracy and for safety with no radiation involved.

Violet

[helenlegs 11]

Precisely. Sounds like a wonderful option.
You would imagine that because any injection could be well positioned even taking anatomical variations into consideration so the separate branches of the nerve could be separately targeted and therefore ruled in nor out of the pathology.
Progress

Helen