In this study we examine the case of a 39-year-old female who sustained injuries in a car accident and was suspected of suffering from either a small neuroma or ilioinguinal nerve compression.
This patient was referred for an MR Neurography of the pelvis following a motor vehicle accident and hernia repair that resulted in dystonia — anterior abdominal wall pain (right greater than left) radiating into the right groin. The patient was to be evaluated for evidence of a small neuroma or ilioinguinal nerve compression.
The MR Neurography imaging showed that the the genitofemoral nerve is hyperintense and there is an area of swelling consistent with a focal constriction or a local neuroma on the right side of the abdomen. There is no gross discontinuity of the nerve with an area of focal increased caliber and intensity consistent with a focal nerve constriction. This is associated with a down-stream area of nerve swelling, also consistent with some nerve irritation.
At the same level on the left side, there is a small swelling within the genitofemoral nerve. These images (depicted below) also demonstrate an area of excess fluid or hyperintensity within the abdominal wall adjacent to the area of the abnormality in the genitofemoral nerve. The ilioinguinal nerves appear essentially normal and without any abnormality along their course.
The impression was focal constriction of genitofemoral nerve at the level of hysterectomy incision on the right side; mild abnormality in left genitofemoral nerve; and an area of fluid, edema or inflammation inside the abdominal wall on the right side. Images were also provided of the sciatic nerves and of the major lumbosacral spinal nerve elements; all of these are within normal limits.
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