Cluneal Nerve

[Diane]

Hi Steve,
We had a request that said “Hip pain, clinical cluneal impingement”.

I think we did a general hip but were stumped with the cluneal nerve as it’s something we don’t see often. It seems the literature online says it can be located using the gluteal medius muscle and the posterior iliac spine and pathology would manifest as a hypoechoic structure and ultrasound is used to guide injections.

Any tips on finding this nerve and its ultrasound’s efficacy for diagnosing cluneal nerve pathology?

Thanks!

[Stephen Bird]

Hi Diane,

Yes, I find them difficult as well,

The patient usually presents with buttock pain and we are asked to inject the nerve.

The guru for this nerve (and most nerves !) is a great friend of mine Ke-Vin Chang.

Ke-Vin is in Taipei and he has published some outstanding articles on tracking these small nerves.

I have attached some of his work for you to enjoy.

Steve.

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