Lab Studies:
N/A
Other Studies:
Transvaginal ultrasound was negative for pelvic organ injury.
Musculoskeletal Ultrasound: On the initial visit, an ultrasound-guided pudendal nerve block was performed close to the ischial spine with 1 ml 40mg/ml Kenalog and 4 ml 1% Lidocaine Case Photo #1 , which provided relief from neuropathic pain, but the primary constant pain in the left perineum continued. Repeat pelvic floor ultrasound, three days later, showed loss of fibrillar pattern, global hypoechogenicity with hyperechogenic lesions within the levator ani suggesting an intrasubstance tear with surrounding soft tissue edema Case Photo #2 . Pain was also reproducible with sonopalpation.
Consultations:
Pelvic Floor Rehabilitation
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