2024 ARRS ANNUAL MEETING - ABSTRACTS

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E5232. Pelvic Blocks: A Primer for Radiology Residents
Authors
  1. Robert Nguyen; No Affiliation
  2. Rebecca Chason; No Affiliation
  3. Dan Laney; No Affiliation
  4. Chelsea Grobe; No Affiliation
  5. Lindsey Rhodes; No Affiliation
  6. Alexandra Fairchild; No Affiliation
Background
Pelvic nerve blocks are available to treat a wide variety of acute and chronic conditions in the female and male pelvis. The acute indications for pelvic nerve blocks are diverse including analgesia for minor urogenital or anorectal surgeries and interventional procedures. Pelvic nerve blocks are also utilized for the treatment of chronic conditions, most notably chronic pelvic pain and malignancy. Chronic pelvic pain is a prevalent condition estimated to affect 26% of women and 16% of men. Chronic pelvic pain includes conditions such as pudendal neuralgia, myofascial pelvic pain, and vulvodynia. The treatment and diagnosis of chronic pelvic pain is complex due to the multifactorial etiology and various presentation of symptoms. The management of chronic pelvic pain is a multidisciplinary approach involving primary care, gynecology, pain management, and interventional radiology. The interventional radiologist has been emerging as a key contributor to diagnosis and treatment of symptoms by performing image guided neural blockades and neurolytic procedures. This educational exhibit aims to explore conditions pelvic blocks are indicated for and the different techniques and imaging modalities available for each block.

Educational Goals / Teaching Points
The goal of this educational exhibit is to understand the indications for pelvic nerve blocks and their role in the treatment of acute and chronic pelvic conditions. This presentation will provide a comprehensive review of the relevant anatomy highlighting the location of the nerve bundles and how to safely access them with image guidance. Participants will gain a better understanding of the distinct benefits and limitations of different modalities including ultrasound (US), CT, and fluoroscopy (FL), when utilized for each block. Additionally, the exhibit will review appropriate clinical work-up and patient selection allowing participants to better apply the concepts presented into practice.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Understanding the options available for pelvic nerve blocks, appropriate patient selection, and imaging modality are key in the care of patients with pelvic pathology and pain. These procedures are highly efficacious when performed on the appropriate patient for the appropriate indication.

Conclusion
Understanding the options available for pelvic nerve blocks, appropriate patient selection, and imaging modality are key in the care of patients with pelvic pathology and pain. These procedures are highly efficacious when performed on the appropriate patient for the appropriate indication.