Nerve Trauma, Entrapment and RSD:

Complex Regional Nerve Pain After Trauma

A)  Sciatic nerve hyperintensity associated with adhesion to a site of pelvic fracture in a patient with new onset reflex sympathetic dystrophy. The RSD symptoms resolved after nerve release surgery. 

B) Deformation in the shape of the sciatic nerve at a site of prior trauma and failed surgical exploration.

B1) This reconstruction in the sagittal plane shows a flattened sciatic nerve with an irregular course instead of the expected straight smooth course.

B2) In the coronal view the sciatic nerve is broad and flat. The two images together show the severe mechanical distortion of the nerve at this site of adhesion. After four years of failed intensive pain management, the symptoms were relieved by nerve release surgery.

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