Perineal Nodular Induration in Cyclists

Bicycling Injuries

“…Saddle sores, ranging from furuncles and folliculitis to nodular induration, may limit riding for a prolonged period. They often require incision and drainage, or surgical excision for the more severe ischial hygroma or ''third testicle'' (accessory testicle or ''biker's nodule'') (28). Time off the bike, warm soaks, cortisone, or antifungal or antibacterial ointment may be considered.…”

Perineal nodular induration: a report of three cases in France

“…In the case of an MRI scan, the lesion appears as a nodule-like mass as a hyposignal with T1 and T2 weighting. 6 An ultrasound of the perineal nodule shows a swelling of the soft tissue, which corresponds to a fibrous hypodermic absorbent zone, with posterior acoustic shadowing, as with patient 3. It does not seem necessary to conduct an anatomopathological examination with the aim of obtaining a presurgery diagnosis.…”

“…However, imaging tests may be performed. In the case of an MRI scan, the lesion appears as a nodule‐like mass as a hyposignal with T1 and T2 weighting …”

“…It does not seem necessary to conduct an anatomopathological examination with the aim of obtaining a presurgery diagnosis. If this type of histology is performed, however, the perineal nodule appears in the form of a pseudocystic formation lined by a dense fibrous capsule with fibrinous content and adjacent areas of aseptic necrosis …”

Retracted Chapter: The Expert View on Bicycling Injuries

“…Perineal nodular induration (PNI) or "biker's nodule" is a fi broblastic pseudotumor that presents not only exclusively in male cyclists' "third testicle" (accessory testicle) but also in female population of cyclists. It develops in the soft tissues of the perineum immediately posterior to the scrotum or in the labial area in women, as a bilateral or single, central or lateralized mass (Gonzalez-Perez et al 2009 ). Surgical excision is often required.…”