• Güleç GG
• Oktay KNK
• Aktaş I
• Yılmaz B

• Adult
• Affiliation / Fatih Sultan Mehmet Training and Research Hospital. Department of Orthopaedics and Traumatology
• Affiliation / Fatih Sultan Mehmet Training and Research Hospital. Department of Physical Medicine and Rehabilitation
• Affiliation / Yeditepe University Hospital. Department of Physical Medicine and Rehabilitation
• Affiliation(G) / Turkey / Istanbul
• Anatomic Variation
• Female
• Injections, Intramuscular
• Male
• Myofascial Pain Syndromes
• Open Access Document
• Piriformis Muscle Syndrome / therapy
• Sciatic Nerve / diagnostic imaging
• Ultrasonography
• Young Adult

Objective: The aim of this article is to present examples of patients in whom piriformis muscle (PM) and sciatic nerve (SN) variations were detected by a diagnostic ultrasound (US)–guided examination and were successfully diagnosed and treated for piriformis syndrome (PS) by US-guided injections.

Clinical Features: This series includes 4 cases. In case 1, a 30-year-old woman with a 7 numeric rating scale (NRS) score for pain (on a 0-10 scale) was evaluated for complaints of left gluteal pain radiating to the thigh for 5 years and right gluteal pain for 2 years. Case 2 involves a 32-year-old man with a 7 NRS score presenting with left gluteal pain radiating to his leg for 1 year. The third case presents a 37-year-old man who had pain (6 NRS score), numbness, and discomfort radiating from the right hip to the leg that lasted for 7 years. Finally, in case 4, a 23-year-old male patient was examined with deep gluteal paresthesia and discomfort on the left side for 1 year.

Intervention and Outcome: Diagnostic US evaluation of the gluteal region for each patient revealed anatomical variations of the SN. In 3 of the cases, corresponding contralateral US images demonstrated similar anatomic variations. Diagnosis of PS in each patient was made by US-guided injection. After the injection of 4 cm3 of lidocaine 2% into the PM, the patients’ complaints resolved almost fully.

Conclusion: The anatomical variations of the SN and PM might be a facilitating factor for myofascial pain syndrome in PS. These cases demonstrate that SN variations could be visualized with the help of diagnostic US.

Author Keywords:  Ultrasonography; Anatomic Variation; Piriformis Muscle Syndrome; Sciatic Nerve; Myofascial Pain Syndromes

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record | PDF