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Piriformis syndrome

Tae Hoon Ro, Lance Edmonds
Piriformis syndrome is an uncommon condition that causes significant pain in the posterior lower buttocks and leg due to entrapment of the sciatic nerve at the level of the piriformis muscle. In the typical anatomical presentation, the sciatic nerve exits directly ventral and inferior to the piriformis muscle and continues down the posterior leg. Several causes that have been linked to this condition include trauma, differences in leg length, hip arthroplasty, inflammation, neoplastic mass effect, and anatomic variations...
2018: Journal of Clinical Imaging Science
Amélie Levesque, Thibault Riant, Stéphane Ploteau, Jérôme Rigaud, Jean-Jacques Labat
Background: The evaluation of chronic pelvic and perineal pain (CPP) is often complex. The patient's description of the pain often appears to be disproportionate to the limited findings on physical examination and/or complementary investigations. The concept of central sensitization may allow better understanding and management of patients with CPP. Objective: The aim of this study was to elaborate a clinical evaluation tool designed to simply identify sensitization in pelvic pain...
March 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Yasaman Safarpour, Bahman Jabbari
This review evaluates the existing level of evidence for efficacy of BoNTs in different pain syndromes using the recommended efficacy criteria from the Assessment and Therapeutic Subcommittee of the American Academy of Neurology. There is a level A evidence (effective) for BoNT therapy in post-herpetic neuralgia, trigeminal neuralgia, and posttraumatic neuralgia. There is a level B evidence (probably effective) for diabetic neuropathy, plantar fasciitis, piriformis syndrome, pain associated with total knee arthroplasty, male pelvic pain syndrome, chronic low back pain, male pelvic pain, and neuropathic pain secondary to traumatic spinal cord injury...
January 31, 2018: Toxicon: Official Journal of the International Society on Toxinology
Z F Huang, D S Yang, Z J Shi, J Xiao
Objective: To assess the morphological parameters of the piriformis muscle through magnetic resonance imaging(MRI) so as to further elucidate the pathogenesis of piriformis syndrome (PS). Methods: From September 2015 to October 2016, 30 suspected PS patients and 30 normal controls were enrolled in this study from the Nanfang Hospital, Southern Medical University. The possible causative factors of the PS in the patients were obtained, and the PS patients were divided into subgroups according to the anatomic site of the tender regions...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Ke-Vin Chang, Wei-Ting Wu, Henry L Lew, Levent Özçakar
Ultrasound has emerged as one of the most utilized tools to diagnose musculoskeletal disorders and to assist in interventions. Traditionally, sonographic examination of the hip joint has been challenging because most of the major structures are deeply situated, thus requiring the use of curvilinear transducer for better penetrance. The posterior lateral hip is a frequent area for musculoskeletal pain and nerve entrapments. Common disorders include greater trochanteric pain syndrome, gluteus medius tendinopathy, piriformis syndrome, pudendal neuralgia and proximal hamstring tendinopathy...
January 11, 2018: American Journal of Physical Medicine & Rehabilitation
Jeffrey Kay, Darren de Sa, Laura Morrison, Emily Fejtek, Nicole Simunovic, Hal D Martin, Olufemi R Ayeni
PURPOSE: To assess the causes, surgical indications, patient-reported clinical outcomes, and complications in patients with deep gluteal syndrome causing sciatic nerve entrapment. METHODS: Three databases (PubMed, Ovid [MEDLINE], and Embase) were searched by 2 reviewers independently from database inception until September 7, 2016. The inclusion criteria were studies reporting on both arthroscopic and open surgery and those with Level I to IV evidence. Systematic reviews, conference abstracts, book chapters, and technical reports with no outcome data were excluded...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kevork Hopayian, Armine Danielyan
PURPOSE: To update the evidence on the clinical features of the piriformis syndrome since the first systematic review published in 2010. METHOD: A systematic review of all case, cross-sectional and prevalence studies. RESULTS: The commonest features reported were: buttock pain, pain aggravated on sitting, external tenderness near the greater sciatic notch and pain on any maneuver that increases piriformis muscle tension, and limitation of straight leg raising...
February 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Zheng Zhang, Xuebing Zhang, Chen Yang, Xiaoyu Wen
We report a case of sciatica that fulfilled the diagnostic criteria for inferior gluteal vein varicosities according to patient history and on magnetic resonance imaging. Since conservative treatment was ineffective, excision-ligation of the varicose vein was performed as recommended in the previous literature. However, pain was only slightly relieved and then aggravated. Reoperation involving wide release and resection of the piriformis outlet was performed. Pain resolved immediately thereafter. We suggest that this case of sciatica resulted from both piriformis entrapment and vein varicosities...
September 2017: Der Orthopäde
Manuel Rodríguez-Piñero, Victoria Vidal Vargas, Aguas Santas Jiménez Sarmiento
No abstract text is available yet for this article.
February 1, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Keizo Wada, Tomohiro Goto, Tomoya Takasago, Daisuke Hamada, Koichi Sairyo
Piriformis muscle syndrome (PMS) is difficult to diagnose by objective evaluation of sciatic nerve injury. Here we report a case of PMS diagnosed by diffusion tensor imaging (DTI) and tractography of the sciatic nerve, which can assess and visualize the extent of nerve injury. The patient was a 53-year-old man with a 2-year history of continuous pain and numbness in the left leg. His symptoms worsened when sitting. Physical examination, including sensorimotor neurologic tests, the deep tendon reflex test, and the straight leg raise test, revealed no specific findings...
October 2017: Skeletal Radiology
Suk Ku Han, Yong Sik Kim, Tae Hyeon Kim, Soo Hwan Kang
BACKGROUND: Piriformis syndrome (PS) is an uncommon disease characterized by symptoms resulting from compression/irritation of the sciatic nerve by the piriformis muscle. Uncertainty and controversy remain regarding the proper diagnosis and most effective form of treatment for PS. This study analyzes the diagnostic methods and efficacy of conservative and surgical treatments for PS. METHODS: From March 2006 to February 2013, we retrospectively reviewed 239 patients who were diagnosed with PS and screened them for eligibility according to our inclusion/exclusion criteria...
June 2017: Clinics in Orthopedic Surgery
S Jengojan, C Schellen, G Bodner, G Kasprian
BACKGROUND: Technical advances in magnetic resonance (MR) and ultrasound-based neurography nowadays facilitate the radiological assessment of the lumbosacral plexus. OBJECTIVE: Anatomy and imaging of the lumbosacral plexus and diagnostics of the most common pathologies. MATERIAL AND METHODS: Description of the clinically feasible combination of magnetic resonance imaging (MRI) and ultrasound diagnostics, case-based illustration of imaging techniques and individual advantages of MRI and ultrasound-based diagnostics for various pathologies of the lumbosacral plexus and its peripheral nerves...
March 2017: Der Radiologe
Lütfiye Pirbudak, Alper Sevinç, Selim Kervancıoğlu, Piraye Kervancıoğlu, Deniz Ateş
Cancer is frequently seen in women of reproductive age. Diagnosis, management of treatment, and safety of the therapeutic approach are particularly important for these patients. Presently described is pain management in a case of pregnancy with malignant mesenchymal tumor. A 23-year-old woman in 30th gestational week presented with severe pain in right hip and back of the right thigh. Piriformis block successfully decreased pain and was followed by pulsed radiofrequency (PRF) to the piriformis muscle. PRF, as a non-neurodestructive method, is a safe and effective method to treat cancer pain in a pregnant patient...
October 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Luis Perez Carro, Moises Fernandez Hernando, Luis Cerezal, Ivan Saenz Navarro, Ana Alfonso Fernandez, Alexander Ortiz Castillo
BACKGROUND: Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome", a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes...
July 2016: Muscles, Ligaments and Tendons Journal
Keizo Wada, Takuya Hashimoto, Ryo Miyagi, Toshinori Sakai, Koichi Sairyo
OBJECTIVE: Piriformis muscle syndrome (PMS) is underdiagnosed. To evaluate the potential of diffusion tensor imaging and diffusion tensor tractography as innovative tools for the diagnosis of PMS by functional assessment of the sciatic nerve, the aims of this study are to assess the reproducibility and to evaluate the changes in the parameters at levels proximal and distal to the piriformis. MATERIALS AND METHODS: Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) of the sciatic nerve at three levels were quantified twice each by two examiners using the fiber-tracking method...
March 2017: Skeletal Radiology
Loren M Fishman, Allen N Wilkins, Bernard Rosner
INTRODUCTION: Piriformis syndrome is entrapment of the sciatic nerve by the piriformis muscle. METHODS: In this article we describe a 56-person randomized, double-blind, controlled study involving physical therapy and incobotulinum toxin A or placebo. Inclusion criteria were 3-SD delay of posterior tibial (PT) or fibular (FN) H-reflexes on flexion, adduction, and internal rotation (FAIR) testing, and normal paraspinal electromyographic findings. Outcome measures included adverse side effects, visual analog scale (VAS) findings, and H-reflex delay on the FAIR test...
August 2017: Muscle & Nerve
Patrick J Battaglia, Kevin D'Angelo, Norman W Kettner
OBJECTIVE: The purpose of this study was to present a narrative review of the literature of musculoskeletal causes of adult hip pain, with special attention to history, physical examination, and diagnostic imaging. METHODS: A narrative review of the English medical literature was performed by using the search terms "hip pain" AND "anterior," "lateral," and "posterior." Additionally, specific entities of hip pain or pain referral sources to the hip were searched for...
December 2016: Journal of Chiropractic Medicine
P S Phadke, A R Gandhi, S A More, R P Joshirao
A-21-year old male admitted with fever and piriformis syndrome, typically associated with gluteal region pain radiating down the thigh, was evaluated and found to have pyomyositis involving piriformis and osteomyelitis with sacroiliac joint affection on radiological imaging. Salmonella serotype typhi was isolated from blood culture. He was treated with intravenous Ceftriaxone for 6 weeks with signs of recovery documented clinically as well as on imaging studies. Salmonella pyomyositis with osteomyelitis in an immunocompetent patient with no previous hematological or endocrine disorder makes this case an unusual presentation...
January 2017: Journal of Postgraduate Medicine
A Gandhi, P Phadke
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Md Abu Bakar Siddiq, Md Shawkat Hossain, Mohammad Moin Uddin, Israt Jahan, Moshiur Rahman Khasru, Neaz Mahmud Haider, Johannes J Rasker
AIMS: To describe a series of piriformis syndrome patient among Bangladesh people with literature review. METHODS: Consecutive 31 piriformis syndrome patients were enrolled. Besides history and clinical examination, piriformis muscle thickness was also measured with diagnostic ultrasound (3.5 MHZ). MRI of lumbar spine, X-rays of lumbo-sacral spine, and pelvis were performed in all patients. Statistical Package for the Social Sciences (SPSS), Windows 8.0, was used for statistical calculation, and univariate analysis of primary data was done...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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