Chronic Groin Pain in Female Cyclists: Consider Pudendal Neuroma as a Possible Cause

ABSTRACT: A 58-year-old female cyclist is experiencing chronic right groin pain, adversely affecting her quality of life and athletic performance. Despite undergoing comprehensive diagnostic evaluations, including pelvic MRI and specialized physical examinations, the primary findings were chondrolabral separation and ischiofemoral impingement. Notably, a pudendal neuroma was identified through ultrasound imaging. The patient received ultrasound-guided corticosteroid injections (Depomedrone 20 mg) and local anesthetic (0.25% bupivacaine 1 mL, with 1% lidocaine for skin and subcutaneous tissues), substantially alleviating symptoms and enhancing functional capacity. This case contributes to the limited literature on pudendal neuroma and highlights an avenue for potential nonsurgical percutaneous image-guided intervention for diagnostic and therapeutic purposes.