Upright MRI's?

Discussion of magnetic resonance imaging and magnetic resonance neurography

Upright MRI's?

Postby bikelover » Sat Mar 29, 2014 1:36 am

Hello everyone. For most of us, our pain is triggered by sitting, or at least in my case, sitting is like an ON/OFF switch....
In my personal view, based on conclusions of what I've read, and heard, the TG surgeries are not foolproof. Also in my experience, conservative management has not really helped. Using a dedicated cushion with the proper hole for the perineum helps making sitting more tolerable, but I still experience pain after a while so such solution, for me, is not taking harm away.
As an engineer, I can't avoid to phantom about what is happening inside our bodies. And I still think, at least in my case, that the nature is very mechanical. I sit and the pain starts to kick in, I stand or lie down, and the pain goes away. Weight is obviously involved, but it is in both standing and sitting, there must be something else at play when we are sitting that is making the harm. Maybe hip flexion or what else is involved anatomically in such position could play a role in understanding what could be the underlying mechanism that is triggering the pain.
So maybe the pudendal nerve is involved, but even if that was solely the case, a nerve irritation, or inflammation, then why even after all these blocks, the nerve still remains irritated?
At least in my personal situation, other than my sitting woes, my body seems perfect or normal when I’m standing or lying on bed. As soon as I sit, something is getting squished…but things weren’t always like this. My brother in law is all into Ironman. He has done it many times. He goes riding every single day of the week. Yet when I ask if he has experienced anything remotely close to the “cyclist syndrome”, we says, not at all. Mind you I have not ridden a bicycle in years, only motorcycle, and not every weekend….
One of the many things that have left me clueless in my journey through all these Doctors is why do they don’t seem curious about what is going on in our bodies, in our pelvises, exclusively while we sit. I mean, if for most of us pain is THE main trigger, why are they not putting a close eye inside our pelvises while we sit. I cannot help but think it might provide some clues as to what is going on inside our bodies...
Where am I getting…..I'm wondering, has anybody tried one of those upright MRI machines where you can stand, sit, etc…?
I’m really thinking into this, but I’m curious if any of us PN sufferers has already tried it….?

For more info, look into these links:

http://www.altushealthsystem.com/imagin ... anner.html
http://www.mri911.com/#!casestudies/cp7n
Last edited by bikelover on Mon Mar 31, 2014 9:36 pm, edited 2 times in total.
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Re: Upright MRI's?

Postby nyt » Sat Mar 29, 2014 1:13 pm

I was aware of this and I sent some information to Dr. Hibner and Dr. Kalinikin about these new MRI's. I think it would make a really interesting study to compare sitting, standing and laying down. Unfortunately, these MRI's are not even 1.5T so gleaming good pelvic data to find the neurovascular bundle of the pudendal nerve would be a challenge. This technology will certainly advance and will provide very useful information on what is normal and abnormal in all three of the above named positions.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
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Re: Upright MRI's?

Postby bikelover » Mon Mar 31, 2014 1:40 pm

You're right, but, an MRN can already tell you possible locations for nerve irritation. If the nerve shows up bright and more thick on an MRN, as far as I've read, that will probably mean inflammation. Along with an upright MRI you could find what could possibly irritate the nerve when we sit. I'm thinking of doing both on my next trip to Houston, If I can spare the cash...
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Re: Upright MRI's?

Postby Violet M » Thu Apr 17, 2014 8:58 pm

Prof Robert has simulated what happens to a cadaver when sitting.

"The course of the nerve is thus very special. It successively traverses three very different regions, describes a curve which drags it around the region of the ischial spine, which it straddles like a violin string on its bridge. The seated position was simulated in the cadaver. It is associated with an ascent of the ischio-anal fat, which becomes applied laterally to the falciform process of the sacrotuberal ligament, so that this is elevated and approximated to the nerve trunk. The latter, contained in the aponeurosis of the obturator internus m., has no means of escape, any more than it has in the gluteal region in the ligamentous grip...since the piriformis [muscle] bars any possibility of upward escape."

Source:http://pudendalhope.org/sites/default/files/PNE_by_Prof_Robert.pdf

It would be interesting to see this if this could be confirmed on an MRI.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Upright MRI's?

Postby Diana10 » Fri Jun 19, 2015 1:07 am

hello fellow PN people. this is Diana10 and it has been awhile since I have been on here. Short Hx, I had female surgery
15 years ago come august, and have been standing all this time.I have been stable on oxy,LYricA,for PN and Elmeron for IC. But about a few months ago I started having back pain. I put it off to long,so am in pain waiting for MRI to be approved. a week yesaterday. I was interested in standing MRI???
I have developed Scoliosis as a result of PN as I also lye on right side every night to sleep, and when have to lay down
During day,same thing. the dr says he can fix it but not how. has no bedside manner and since I am on pain meds I can,t
Possibly need pain relief. just something,NOT narcotics. Did some cortisone but done with it so?????
Is there anyone out there that is this debilited by PN? Read some notes on previous pages. Don,t have surgery to try
And fix it. I didn,t listen,went to Johns Hopkins. I wrote my story somewhere,right now I have to leave you as my buttocks are burning like sunburn. Will write. Response to this treatment. My prayers for all you. Diana
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Re: Upright MRI's?

Postby Diana10 » Fri Jun 19, 2015 1:07 am

hello fellow PN people. this is Diana10 and it has been awhile since I have been on here. Short Hx, I had female surgery
15 years ago come august, and have been standing all this time.I have been stable on oxy,LYricA,for PN and Elmeron for IC. But about a few months ago I started having back pain. I put it off to long,so am in pain waiting for MRI to be approved. a week yesaterday. I was interested in standing MRI???
I have developed Scoliosis as a result of PN as I also lye on right side every night to sleep, and when have to lay down
During day,same thing. the dr says he can fix it but not how. has no bedside manner and since I am on pain meds I can,t
Possibly need pain relief. just something,NOT narcotics. Did some cortisone but done with it so?????
Is there anyone out there that is this debilited by PN? Read some notes on previous pages. Don,t have surgery to try
And fix it. I didn,t listen,went to Johns Hopkins. I wrote my story somewhere,right now I have to leave you as my buttocks are burning like sunburn. Will write. Response to this treatment. My prayers for all you. Diana
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