High-Resolution Ultrasound of the Posterior Femoral Cutaneous Nerve in Pain Intervention and Assessment

High-Resolution Ultrasound of the Posterior Femoral Cutaneous Nerve in Pain Intervention and Assessment

The posterior femoral cutaneous nerve (PFCN) is a sensory nerve originating from the sacral plexus (S1–S3) and plays a crucial role in the innervation of the posterior thigh, inferior buttock, and perineal region. Highresolution ultrasound (HRUS) has emerged as an effective imaging modality for its anatomical visualization and clinical assessment. We reviewed anatomical studies and imaging techniques for PFCN identification, focusing on HRUS-based approaches. Cadaveric studies and clinical applications were examined to assess HRUS utility in PFCN-related conditions. HRUS demonstrates a 96% success rate in PFCN identification. Optimal imaging involves patient positioning in a prone posture, using a high-frequency linear probe (12–18 MHz) with transverse and longitudinal scanning. The nerve can be traced from its emergence at the gluteal fold to its distal course along the biceps femoris and popliteal fossa. HRUS enables detection of neuropathies, nerve entrapments, and traumatic injuries, guiding interventions such as nerve blocks, hydrodissection, and neuroablative procedures. HRUS is a reliable tool for PFCN visualization, enhancing diagnostic accuracy and minimally invasive therapeutic interventions. The detailed sonoanatomy presented in this report facilitates improved clinical assessment and management of PFCN-related disorders.