146 results match your criteria Injection Piriformis

Computed Tomography-Guided Percutaneous Infiltrations for Piriformis Syndrome: A Single-Center Retrospective Study.

J Long Term Eff Med Implants 2020 ;30(2):113-118

Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece.

Piriformis syndrome (PS), first described by Yeoman in 1928, is a general term referring to low back pain, sciatica, and instability. PS has a 6% incidence rate worldwide. In this study, we aim to retrospectively evaluate the effectiveness of computed tomography (CT)-guided percutaneous infiltration in a series of consecutive PS patients who have symptoms that are refractory to conservative therapies. Read More

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January 2020

Complete resolution of recurrent piriformis syndrome after piriformis resection with 3 years' follow up: A case report.

Int J Surg Case Rep 2020 20;77:576-579. Epub 2020 Nov 20.

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Introduction: Piriformis syndrome (PS) is an uncommon neuromuscular condition characterized by buttock pain radiating to the leg. Although the goal of PS treatment is symptom relief, it is difficult in some patients using conservative treatment alone.

Presentation Of Case: A 72-year-old male underwent piriformis resection after failed sequential steroid injection of the piriformis. Read More

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November 2020

Guidelines for botulinum neurotoxin injections in piriformis syndrome.

Clin Anat 2020 Dec 21. Epub 2020 Dec 21.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea.

Background: The piriformis muscle is normally involved in piriformis syndrome and can be treated with botulinum neurotoxin using several different injection methods. However, definitive injection guidelines for the muscle have not been reported previously.

Aims: This study aimed to determine the ideal area for injections based on the intramuscular nerve distribution as obtained using a modified Sihler's staining technique. Read More

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December 2020

Piriformis syndrome: pain response outcomes following CT-guided injection and incremental value of botulinum toxin injection.

Diagn Interv Radiol 2021 Jan;27(1):126-133

Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA; Department of Orthopedics, UT Southwestern Medical Center, Dallas, Texas, USA.

Purpose: Piriformis syndrome is a common pain condition affecting the buttock and posterior hip with or without radiation to the leg, and management of the condition involves many treatments. In this study, we hypothesize that a CT-guided injection with botulinum toxin is more effective in providing pain relief than a CT-guided injection without Botox.

Methods: Overall, 97 consecutive patients with piriformis syndrome presented for a CT-guided injection of the piriformis muscle and perineural injection of the sciatic nerve. Read More

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January 2021

[Piriformis syndrome. Treatment under control of CT fluoroscopy].

Zh Nevrol Psikhiatr Im S S Korsakova 2020 ;120(10):85-90

Pirogov Russian National Research Medical University, Moscow, Russia.

Objective: To demonstrate one of the effective methods of treatment of the piriformis syndrome under the control of a highly technological visualization method.

Material And Methods: Eight patients (7 women and 1 man), aged 44 to 63 years, with piriformis syndrome, were studied from 2016 to 2018. The main complaints of the patients were pain in the lumbosacral spine with irradiation to the gluteal region and/or legs. Read More

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November 2020

Ultrasound-guided trigger point injection for piriformis syndrome in the emergency department.

J Am Coll Emerg Physicians Open 2020 Oct 24;1(5):876-879. Epub 2020 Jun 24.

Department of Emergency Medicine The Brooklyn Hospital Center Brooklyn New York USA.

Piriformis syndrome, a myofascial pain disorder characterized by deep gluteal pain that radiates to the ipsilateral lower back and/or posterior thigh, is an underreported cause of low back pain frequently misdiagnosed in the emergency department (ED). Often refractory to oral pain medications, this syndrome can be debilitating. Ultrasound-guided trigger point injection of the piriformis muscle can treat piriformis syndrome, but no previous reports exist in the emergency medicine literature. Read More

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October 2020

A minimally invasive surgical approach for the treatment of piriformis syndrome: a case series.

Chin Neurosurg J 2020 30;6. Epub 2020 Mar 30.

Department of Neurosurgery, the George Washington University, 2150 Pennsylvania Avenue, NWSuite 7-420, Washington, DC 20037 USA.

Background: Piriformis syndrome accounts for approximately 6% of patients who present with sciatic pain. There are many treatment options ranging from physical therapy, to trigger point injections, to surgical intervention. We discuss a surgical method that represents a minimally invasive technique for the treatment of piriformis syndrome. Read More

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A new treatment modality in piriformis syndrome: Ultrasound guided dry needling treatment.

Agri 2020 Aug;32(3):175-176

Department of Radiology, Sarıkamış State Hospital, Kars, Turkey.

Piriformis syndrome is a painful entrapment neuropathy caused by compression of the sciatic nerve under piriformis muscle for structural or acquired reasons. Myofascial pain syndrome is the most common cause. There are physical therapy modalities, stretching exercises, injection therapies and medical treatment approaches. Read More

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Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve.

Yeungnam Univ J Med 2021 Apr 21;38(2):148-151. Epub 2020 Jul 21.

Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.

Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. Read More

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Clinical usefulness of ultrasound as an early diagnostic tool for neuroleukemiosis -a case report.

Korean J Anesthesiol 2021 02 5;74(1):65-69. Epub 2020 Jun 5.

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: Neuroleukemiosis is a rare complication of leukemia. The diagnosis may be delayed owing to non-specific symptoms and the need for special diagnostic modalities.

Case: A 70-year-old man in his sixth year of remission from acute myeloid leukemia was referred to the pain clinic for shooting and radiating pain in the left posterior leg. Read More

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February 2021

Deep gluteal syndrome as a cause of posterior hip pain and sciatica-like pain.

Bone Joint J 2020 May;102-B(5):556-567

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Department of Orthopedic Surgery, Seoul National University College of Medicine Seongnam, South Korea.

Deep gluteal syndrome is an increasingly recognized disease entity, caused by compression of the sciatic or pudendal nerve due to non-discogenic pelvic lesions. It includes the piriformis syndrome, the gemelli-obturator internus syndrome, the ischiofemoral impingement syndrome, and the proximal hamstring syndrome. The concept of the deep gluteal syndrome extends our understanding of posterior hip pain due to nerve entrapment beyond the traditional model of the piriformis syndrome. Read More

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Deep gluteal syndrome is defined as a non-discogenic sciatic nerve disorder with entrapment in the deep gluteal space: a systematic review.

Knee Surg Sports Traumatol Arthrosc 2020 Oct 3;28(10):3354-3364. Epub 2020 Apr 3.

Department of Health Research Methods, Evidence, and Impact, McMaster University, 1200 Main St. W, Hamilton, ON, L8N 3Z5, Canada.

Purpose: Clinicians are not confident in diagnosing deep gluteal syndrome (DGS) because of the ambiguity of the DGS disease definition and DGS diagnostic pathway. The purpose of this systematic review was to identify the DGS disease definition, and also to define a general DGS diagnostic pathway.

Methods: A systematic search was performed using four electronic databases: PubMed, MEDLINE, EMBASE, and Google Scholar. Read More

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October 2020

Case report and review of the potential role of the Type A piriformis muscle in dynamic sciatic nerve entrapment variant of piriformis syndrome.

Surg Radiol Anat 2020 Oct 28;42(10):1237-1242. Epub 2020 Feb 28.

Medical Department, Fremantle Football Club, Cockburn Central, WA, Australia.

Piriformis syndrome (PS) is an underdiagnosed but common cause of chronic buttock pain and sciatica. Anatomical variants of the piriformis muscle and sciatic nerve have not been thought to be significant in the pathophysiology of PS however, recent description of the piriformis musculotendinous junction has identified a common variant that we believe frequently results in dynamic sciatic nerve entrapment at the infra-piriformis fossa. We performed ultrasound guided low-dose Botulinum Toxin-A (BTX-A) injection to the lower piriformis muscle belly in an elite Australian Rules football player with PS and Type A piriformis muscle to relieve symptomatic sciatic nerve compression. Read More

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October 2020

[The piriformis syndrome-a special indication for botulinum toxin].

W Hermann

Nervenarzt 2020 Feb;91(2):99-106

SRO AG Langenthal, St. Urbanstraße 67, 4900, Langenthal, Deutschland.

The piriformis syndrome (PiS) is a possible cause of gluteal pain radiating into the legs. From a pathophysiological anatomical point of view a division into primary and secondary PiS is made. A primary PiS is based on variants of the course of the sciatic nerve with respect to the piriformis muscle. Read More

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February 2020

Piriformis Injection: An Ultrasound-Guided Technique.

Arthrosc Tech 2019 Dec 13;8(12):e1457-e1461. Epub 2019 Nov 13.

Nashville Hip Institute, Nashville, Tennessee, U.S.A.

Piriformis syndrome is an elusive condition that likely is overlooked and overdiagnosed in equal proportions. Image-guided injection of the muscle is an essential element in the assessment and management of this disorder. Ultrasonography allows visualization of the anatomy of the piriformis and its relation with the sciatic nerve. Read More

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December 2019

US-guided Musculoskeletal Interventions in the Hip with MRI and US Correlation.

Radiographics 2020 Jan-Feb;40(1):181-199. Epub 2019 Nov 22.

From the Department of Radiology, University of British Columbia, Royal Columbian Hospital, 300 Columbia St E, New Westminster, BC, Canada V3L 3W7 (J.I.B.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (B.Y.C.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.M., K.S.L.).

Hip pain is a commonly reported primary symptom with many potential causes. The causal entity can remain elusive, even after clinical history review, physical examination, and diagnostic imaging. Although there are many options for definitive treatment, many of these procedures are invasive, are associated with risk of morbidity, and can be unsuccessful, with lengthy revision surgery required. Read More

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February 2021

Effect of piriformis injection on neuropathic pain.

Agri 2019 Nov;31(4):178-182

Department of Algology, Health Sciences University, Şişli Hamidiye Etfal Hospital, Health Research and Application Center, İstanbul, Turkey.

Objectives: The aim of this study was to investigate the effect of a piriformis injection on neuropathic pain in patients with piriformis syndrome.

Methods: Thirty patients with unilateral hip and/or leg pain, a positive FAIR test (increased H-reflex latency with Flexion, Adduction and Internal Rotation), and a trigger point at the piriformis muscle were enrolled in this prospective study. All of the patients exhibited neuropathic pain scored according to the Douleur Neuropathique 4 (DN4) of ≥4 for at least 6 months. Read More

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November 2019

Relapsing piriformis syndrome treated with botulinum toxin injections.

BMJ Case Rep 2019 Aug 9;12(8). Epub 2019 Aug 9.

Neurology, Neurocenter of Southern Switzerland, Lugano, Switzerland.

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Anatomical causes of compression of the sciatic nerve in the pelvis. Piriform syndrome.

Rev Esp Cir Ortop Traumatol 2019 Nov - Dec;63(6):424-430. Epub 2019 Jul 29.

Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.

Objective: The piriformis syndrome is one of the etiologies of pelvic pain due to the sciatic nerve's entrapment by the piriformis muscle. Nowadays this syndrome might be difficult to be diagnosed. The aim of this study is to know the prevalence of anatomic variations in our population that may contribute to the appearance of piriformis syndrome. Read More

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Quadratus Femoris muscle causing deep gluteal syndrome: A rare cause of refractory sciatica of extraspinal origin in the presence of an anatomic variation.

J Back Musculoskelet Rehabil 2019 ;32(4):667-670

Department of Oncologic and Degenerative Spine Surgery, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy.

Background: Sciatica of extraspinal origin represents both a diagnostic and a therapeutic challenge for spine specialists. Among these, quadratus femoris muscle (QF) is often overlooked as a pain-generator.

Reported Case: A 62-year old man was referred from general practitioner for isolated sciatica in the left leg, refractory to conservative treatments. Read More

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December 2019

Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment.

PM R 2019 08 22;11 Suppl 1:S54-S63. Epub 2019 Jul 22.

Division of Physical Medicine and Rehabilitation, Department of Orthopaedics, Washington University School of Medicine, St. Louis, MO.

Piriformis syndrome is a form of sciatica caused by compression of the sciatic nerve by the piriformis muscle. It is a relatively uncommon, but not insignificant, cause of sciatica. The diagnosis of piriformis syndrome is complicated by the large differential diagnosis of low back and buttock pain with many diagnoses having overlapping symptoms. Read More

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The Safe Gluteoplasty: Anatomic Landmarks to Predict the Superior and Inferior Gluteal Veins.

Eplasty 2019 19;19:e8. Epub 2019 Mar 19.

Division of Plastic Surgery, General Surgery Department, University of Louisville, Louisville, Ky.

The increase in demand for gluteal fat grafting seen in recent years in the United States has not been met with an equal gain in knowledge of the perils of this anatomic territory. The purpose of this study was to identify anatomic landmarks that can be readily used by surgeons to identify the takeoff of the superior and inferior gluteal veins. Six fresh cadaveric gluteal specimens were dissected at the University of Louisville anatomy laboratory. Read More

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[Surgical treatment of proximal femoral fractures in high-risk geriatric patients under peripheral regional anesthesia : A clinical case series].

R Seidel E Barbakow

Anaesthesist 2019 02 5;68(2):108-114. Epub 2019 Feb 5.

Klinik für Anästhesiologie, HELIOS-Kliniken Schwerin, Wismarsche Straße 393-7, 19049, Schwerin, Deutschland.

The authors describe in a clinical case series (n = 7) of older (age 78-95 years) high-risk patients the successful surgical treatment of proximal femoral fractures in a peripheral regional anesthesia technique. After positioning on the non-fractured side, a double injection technique (dual guidance concept: sonography plus nerve stimulation) was chosen. The injections were performed parasacrally (blockade of the sacral plexus under the piriformis muscle) and lumbar-paravertebrally (psoas compartment block and transmuscular quadratus lumborum block). Read More

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February 2019

Epidemiology and etiology of secondary piriformis syndrome: A single-institution retrospective study.

J Clin Neurosci 2019 Jan 24;59:209-212. Epub 2018 Oct 24.

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address:

Piriformis syndrome (PS) is a rare etiology of extra-spinal sciatica in which pathologies associated with or around the piriformis muscle (PM) irritate the adjacent sciatic nerve (SN), however, there is scarcity in the literature regarding its exact etiologies, thus, we performed a retrospective study to elucidate the epidemiology of PS and assess various causes of the syndrome. Our study included patients assessed at our institution who presented with sciatica of non-spinal origin between May 2014 and December 2015. Radiology reports of all patients who received pelvic MRI were examined for positive findings involving PM and SN. Read More

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January 2019

EMG in piriformis syndrome diagnosis: Reliability of peroneal H-reflex according to results obtained after surgery, Botox injection and medical treatment.

J Clin Neurosci 2019 Jan 28;59:55-61. Epub 2018 Nov 28.

Orthopedic Surgery Department, Sacré-Coeur Hospital, P.O. Box 116, Hazmieh, Lebanon.

Diagnosing piriformis syndrome (PS) throughout the past decades was not that easy, however peroneal H-reflex was proved as reliable test for PS with the change in wave amplitude and delay in conduction as parameters for diagnosis. We interpreted these parameters according to treatment's results carried out for patients presenting clinical PS, aiming to define a threshold value for peroneal H-reflex delay to accurately diagnose. A retrospective mono-centric review of 27 patients, 9 females and 18 males, aged 22-65 years, benefited from peroneal H-reflex test and treated for clinical PS. Read More

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January 2019

The effect of polydeoxyribonucleotide on the treatment of radiating leg pain due to cystic mass lesion in inner aspect of right sciatic foramen: A CARE compliant case report.

Medicine (Baltimore) 2018 Oct;97(41):e12794

Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.

Rationale: Radiating leg pain usually originates from the lumbar spine and occasionally from peripheral lesions. Here we report a case involving a patient with radiating pain in the right leg who exhibited 2 suspicious lesions, including 1 spinal lesion and 1 extraspinal cystic mass lesion, on magnetic resonance imaging. Polydeoxyribonucleotide sodium (PDRN) was recently noted as such a substitute. Read More

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October 2018

Letter to the editor involving the article 'Piriformis muscle syndrome: A cross-sectional imaging study in 116 patients and evaluation of therapeutic outcome'.

Eur Radiol 2018 Dec 19;28(12):5354-5355. Epub 2018 Jun 19.

Department of Physical Medicine and Rehabilitation, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.

Key Points: • Lack of use of local injection test to confirm the diagnosis may lead to miss the diagnosis of PMS of myofascial origin. • Piriformis muscle syndrome should be diagnosed on the basis of clinical symptoms, specific physical examinations, and positive response to local injection. • Sciatic nerve entrapment is not a must in the diagnosis of PMS and PMS is mostly myofascial in origin. Read More

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December 2018

Musculus piriformis syndrome: Localization and injection therapy-Comment to letter from Mayo-Moldes M et al. [1].

Scand J Pain 2012 Jul 1;3(3):172. Epub 2012 Jul 1.

Oslo University and Oslo University Hospital, Departments of Pain Management and Research and Anaesthesiology, Rikshospitalet, Oslo, Norway.

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Piriformis muscle injection guided by sciatic nerve stimulation: Quick, simple, and safe technique.

Scand J Pain 2012 Jul 1;3(3):170-171. Epub 2012 Jul 1.

Department of Anesthesiology, Hospital Meixoeiro, Complexo, Hospitalario Universitario de Vigo, Vigo, Spain.

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Targeted Ultrasound-Guided Perineural Hydrodissection of the Sciatic Nerve for the Treatment of Piriformis Syndrome.

Ultrasound Q 2019 Jun;35(2):125-129

NYU Langone Medical Center, Department of Radiology, Division of Musculoskeletal Radiology, Center for Musculoskeletal Care, New York, NY.

Piriformis syndrome is a common cause of lumbar, gluteal, and thigh pain, frequently associated with sciatic nerve symptoms. Potential etiologies include muscle injury or chronic muscle stretching associated with gait disturbances. There is a common pathological end pathway involving hypertrophy, spasm, contracture, inflammation, and scarring of the piriformis muscle, leading to impingement of the sciatic nerve. Read More

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