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Genicular Nerve Radiofrequency Ablation Before and After Magnetic Resonance Imaging Anatomical Mapping: Case Study
Terence Hillery1, Suzanna Shermon1, David Di Lorenzo1
1Case Western Reserve University/MetroHealth, Pain Division, Department of Physical Medicine and Rehabilitation, Cleveland, OH.
Pain Medicine Case Reports
|September 16, 2025
Summary
Radiofrequency ablation (RFA) for chronic knee pain offers relief when targeting genicular nerves (GN). MRI-guided RFA improved probe placement and provided sustained pain relief in a young patient.
Area of Science:
- Pain Management
- Interventional Radiology
- Anatomy
Background:
- Chronic knee pain significantly impacts morbidity.
- Radiofrequency ablation (RFA) of genicular nerves (GN) is a potential treatment.
- Accurate RFA probe placement is crucial but challenged by uncertain GN anatomy.
Purpose of the Study:
- To evaluate the effectiveness of MRI-guided genicular nerve radiofrequency ablation for chronic knee pain.
- To assess the role of MRI in improving probe placement for genicular nerve targeting.
Main Methods:
- A case report of a 21-year-old male with severe knee pain due to Hoffa's fat impingement.
- Genicular nerve blocks were performed, followed by RFA.
- RFA probe placement was guided by MRI-mapped genicular nerve neurovascular bundle location.
Main Results:
- Initial RFA provided 90% pain relief for 4 weeks.
- MRI-guided RFA resulted in 100% left knee pain relief at 8 weeks.
- The patient experienced sustained pain relief post-procedure.
Conclusions:
- MRI-mapped genicular nerves can aid in planning RFA procedures.
- Improved probe and nerve apposition may enhance treatment effectiveness.
- This approach suggests a potential for improved outcomes in managing chronic knee pain.
