Posterior Femoral Cutaneous Nerve

[KC17]

Hi everyone,

02-Lumbar_Surface Anatomy-PS-04-2006.pptx

My fiance and I had a rather humorous night last night as we essentially drew on my back and butt as described in the following power point. I really didn't know where any of this was located and it really helped me to identify some of the major anatomical landmarks of this region.

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Gluteus Image.docx

Looking at this picture and comparing my gluteal drawing, it appears that at the point of the inferior gluteal nerve (labeled IGN on slide 8 of the power point) one would feel pain or at least increased sensitivity because the pudendal nerve passes close to this region. I however have no pain in this region at all, nor anywhere close for that matter. Much of my gluteal pain, arises more lateral at the location where the posterior femoral cutaneous nerve lies. In fact, I have a silver dollar sized area nearly atop the sciatic nerve of my gluteal drawing that if I superficially scratch I can elicit clitoral pulling.

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Further research of the Posterior Femoral Cutaneous Nerve led me to this article, discussing both this nerve and its perineal branch and the pudendal nerve.

http://thejns.org/doi/pdf/10.3171/2008.11.JNS081248


These two nerves appear to communicate and of particular interest to me is the course of the PBPFCN and my areas of pain. Most of my pain is again located in that dollar sized area, the ischial tuberosity, labium majus and the clitoris. The article suggests that "a portion of the penis/clitoris." may be supplied by the perineal branch of the PFCN and it describes in detail how my other areas are innervated by this nerve as well. This has given me a lot of food for thought, because I feel that this nerve can be implicated in my pain, and that via its communication with the pudendal nerve the problem has gotten much worse. One week and I guess Dr. Potter may be able to help identify what's going on in there.

Anyway, I hope someone finds these articles/pictures helpful or at the very least, if somebody attempts the drawing, a bit humorous


-Krista

[nyt]

Krista, thanks for the great links. May explain the class of pudendal patients who don't get relief from surgery they really had posterior femoral cutaneous nerve entrapment instead or patients may have both. Will have to try the drawing exercise, I see why you had so much fun.

[sgrandy]

Thanks for posting that info, Krista! It was really helpful to me especially since I seem to be one of those people that has an awful hard time figuring out pictures of the pelvic anatomy. Interestingly, I also have a spot on my rear end that, when scratched, illicits a pulling sensation in the clitoris even though I typically don't have pain in that area and there is also no sexual disfunction there either...very strange! I go through long periods of been asymptomatic and even then, I can still cause that feeling my clitoris if I scratch that area although not consistently.

Before all this started 5 years ago, I didn't realize how complicated the human body was! I would love to go back to that ignorance! The drawing thing is interesting...might be an amusing way for the hubby and I to pass some time!!

Stephanie

[KC17]

Great! I'm glad you are find the links useful.

Nyt- I think you might be right, after reading this article and a few others it does appear that this nerve may play a role in pelvic pain, if not directly, then possibly through communication with the pudendal nerve.

Stephanie- That IS interesting that you also can scratch an area and elicit the pulling sensation. If you do the drawing I'd love to know where that area falls in relation to some of the landmarks the drawing provides. You are right in saying that the the human body is complicated, I too never knew the extent until I started researching stuff as it relates to the pelvis.

[sgrandy]

It is a truly bizarre symptom and I do find it strange that it can happen even if I have no other pelvic pain (my symptoms remit and relapse). I really wish I could be one of those people that gets to live in ignorant bliss about pelvic pain!

I'm planning on getting the hubby to do the drawing once I go shopping on the weekend and pick up a washable marker (never thought I would be buying a marker for this purpose!). I feel so bad for my hubby though...I'm sure he is massively sick of looking at my behind (and hearing about it) at this point...not that he ever complains but getting him to draw on my bum might inject a little humor into this ordeal! You know what they say: "if you don't laugh you cry". I'll report back on exactly where the spot is!

[Cora]

Krist and others, when I was in PT with Rhonda K- she endlessly talked about the PCFN as a likely culprit.

Cora

[paulette]

Krista,
Have you found out the results of your MRI yet? I would like to know if there is only one physician in the U.S. who can read a 3T MRI when it concerns the pudendal nerve? I live near Denver, and there are a couple of places that have a 3T MRI. The radiologist at one place said he would be willing to try doing an MRI for that purpose, even though it would be complicated with the hardware in my back. Does it take special training to read a MRI for pudendal nerve entrapment??? Thanks for any input.

[pianogal]

Paulette,
When I called Dr. Potter's office asking them if I could just have a 3Tesla MRI in my area and ask Dr. Potter to read it, they said no... because it is not the machine, but the fact that she knows the right locations to take the images. So the images would not be taken in the right locations. I would hate for you to waste your chance on getting it with the wrong person. Perhaps you can get your 3Tesla operating person to get in touch with Dr. Potter and ask what images need to be taken specifically?

[paulette]

Krista,
Thank you for replying. I think I will do what you suggested, as far as having the radiologist get in touch with Dr. Potter. This information needs to be disseminated! I feel bad for you. You are so young and have gone through so much. Keep us posted. Paulette