Magnetic resonance neurography for the diagnosis of extrapelvic sciatic endometriosis

• Verfasst von: Pham, Mirko [VerfasserIn]
• Verfasst von: Sommer, Claudia [VerfasserIn]
• Verfasst von: Wessig, Carsten [VerfasserIn]
• Verfasst von: Monoranu, Camelia-Maria [VerfasserIn]
• Verfasst von: Pérez, José [VerfasserIn]
• Verfasst von: Stoll, Guido [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Titel: Magnetic resonance neurography for the diagnosis of extrapelvic sciatic endometriosis
• Verf.angabe: Mirko Pham, Claudia Sommer, Carsten Wessig, Camelia-Maria Monoranu, José Pérez, Guido Stoll, and Martin Bendszus
• E-Jahr: 2010
• Jahr: 10 February 2010
• Umfang: 4 S.
• Fussnoten: Gesehen am 03.05.2023
• Titel Quelle: Enthalten in: Fertility and sterility
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1950
• Jahr Quelle: 2010
• Band/Heft Quelle: 94(2010), 1 vom: Feb., Seite 351.e11-351.e14
• ISSN Quelle: 1556-5653
• DOI: doi:10.1016/j.fertnstert.2009.12.046
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Extrapelvic endometriosis
• Sach-SW: magnetic resonance imaging
• Sach-SW: magnetic resonance neurography
• Sach-SW: sciatic neuropathy
• K10plus-PPN: 1844464563

Abstract

Objective - To illustrate magnetic resonance neurography findings of severe sciatic injury and muscle denervation related to deep gluteal endometriosis at the sciatic notch. - Design - Case report. - Setting - Academic teaching hospital. - Patient(s) - A 39-year-old woman with a 4-year history of sciatica related to the menstrual cycle. - Intervention(s) - Surgical exploration of the sciatic notch for diagnostic confirmation, external neurolysis of the sciatic nerve, and eventual pharmacologic treatment. - Main Outcome Measure(s) - Magnetic resonance neurography imaging revealed severe neuropathic injury and muscle denervation related to a deep infiltrative endometriotic focus at the sciatic notch, which was confirmed histologically on surgical exploration. Detailed electrodiagnostic and clinical neurologic examinations at initial presentation and during follow-up were obtained for further assessment of nerve degeneration, muscle denervation, and clinical recovery. - Result(s) - Initial gynecologic and eventual laparoscopic evaluation on persisting complaints were without pathological findings. When a progressive weakness of the leg was noted, magnetic resonance neurography revealed a severe axonal damage to the sciatic nerve and denervation of distal target muscles related to a diffuse infiltrative lesion at the sciatic notch. On surgical exploration, extragenital endometriosis was confirmed histologically. Considerable improvement in pain and strength occurred after pharmacologic therapy with a GnRH analogue. - Conclusion(s) - This is the first report to describe imaging findings of magnetic resonance neurography in severe neuropathic injury of the sciatic nerve and subsequent muscle denervation related to a deep infiltrative gluteal endometriotic focus.