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Ultrasound-guided injections in pelvic entrapment neuropathies

Authors
  • Matičič, Urša Burica1
  • Šumak, Rok2
  • Omejec, Gregor3
  • Salapura, Vladka4
  • Snoj, Žiga4
  • 1 Faculty of Medicine, University of Ljubljana, Vrazov trg 2, Ljubljana , (Slovenia)
  • 2 Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor , (Slovenia)
  • 3 Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Zaloška 7, Ljubljana , (Slovenia)
  • 4 Radiology Institute, University Medical Centre Ljubljana, Zaloška 7, Ljubljana , (Slovenia)
Type
Published Article
Journal
Journal of Ultrasonography
Publisher
Exeley Inc.
Publication Date
Jun 07, 2021
Volume
21
Issue
85
Identifiers
DOI: 10.15557/JoU.2021.0023
Source
Exeley
Keywords
Disciplines
  • Medicine
License
Green

Abstract

Pelvic entrapment neuropathies represent a group of chronic pain syndromes that significantly impede the quality of life. Peripheral nerve entrapment occurs at specific anatomic locations. There are several causes of pelvic entrapment neuropathies, such as intrinsic nerve abnormality or inflammation with scarring of surrounding tissues, and surgical interventions in the abdomen, pelvis and the lower limbs. Entrapment neuropathies in the pelvic region are not widely recognized, and still tend to be underdiagnosed due to numerous differential diagnoses with overlapping symptoms. However, it is important that entrapment neuropathies are correctly diagnosed, as they can be successfully treated. The lateral femoral cutaneous nerve, ischiadic nerve, genitofemoral nerve, pudendal nerve, ilioinguinal nerve and obturator nerve are the nerves most frequently causing entrapment neuropathies in the pelvic region. Understanding the anatomy as well as nerve motor and sensory functions is essential in recognizing and locating nerve entrapment. The cornerstone of the diagnostic work-up is careful physical examination. Different imaging modalities play an important role in the diagnostic process. Ultrasound is a key modality in the diagnostic work-up of pelvic entraptment neuropathies, and its use has become increasingly widespread in therapeutic procedures. In the article, the authors describe the background of pelvic entrapment neuropathies with special focus on ultrasound-guided injections.

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