85 - Hypertrophy of Pelvic Floor Muscles in Patients Receiving Therapeutic Botulinum Toxin Injections for High Tone Pelvic Floor Dysfunction

Sunday, April 12, 2026

3:36 PM - 3:45 PM ET

Author/Co-author(s)

CD

Casey Duvall, MD

research fellow
LSUHSC New Orleans Department of Radiology, United States
SS

Stacey Scheib, MD

Associate Professor of Clinical Obstetrics and Gynecology
LSU Health New Orleans, United States
CH

Claire Holmes, MD

resident physician
LSU Health New Orleans, United States
Peyton Hopkins, MD

Research Fellow
LSUHSC - New Orleans, United States
KG

Katelyn Gill, BS

Medical Student
LSUHSC - New Orleans, United States

Presenting Author(s)

Alexandra Fairchild, MD, FSIR (she/her/hers)

Assistant Professor of Radiology
LSU Health, United States

Purpose: Pelvic floor muscle hypertonicity is a common cause of chronic pelvic pain (CPP) that can be treated with targeted muscle injections and blocks. This study aims to determine if high tone pelvic floor dysfunction (HTPFD) exhibits muscle alterations CT imaging.

Materials and Methods: This is a retrospective, IRB approved and HIPPA compliant study. The non-contrast, axial CT images of 57 individuals ages 18-40 referred to interventional radiology for pelvic muscle chemodenervation and/or pelvic blocks between January 2017 and August 2025 were compared to 11 age-matched control patients with no history of pelvic pain or dysfunction. The puborectalis angle and obturator internis (OI) muscle area were measured at the level of the pubic symphysis. The piriformis muscles were measured at their largest point on axial CT. Univariate data analyses were performed with p< 0.05 considered to be statistically significant.

Results: Patient demographics and results are summarized in Table 1. Patients diagnosed with HTPFD were noted to have increased OI and piriformis muscle area when compared to the control group. The OI was also noted to have higher Hounsfield units in the HTPFD group. There was no significant difference in levator muscle angle between the two groups.

Conclusion: This study showed that OI and piriformis hypertrophy is a sign on CT imaging that can be used to aid in the diagnosis of HTPFD. Further research is needed to investigate if these and other CT findings may aid in the diagnosis and treatment of HTPFD.