161 results match your criteria Injection Piriformis


A case of severe sciatica caused by a lymphocele after renal transplantation.

JA Clin Rep 2022 May 30;8(1):37. Epub 2022 May 30.

Department of Anesthesiology, School of Medicine, Iwate Medical University, 2-1-1 Idai-dori, Yahaba-cho, Shiwa-gun, Iwate, 028-3695, Japan.

Background: Sciatica is commonly caused by lumbar spinal disease. However, it can also be caused by tumors, infectious diseases, or muscle entrapment. We present a case of sciatica caused by a lymphocele after renal transplantation. Read More

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Trigger Point Injections.

Phys Med Rehabil Clin N Am 2022 05;33(2):307-333

Department of Anesthesiology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, MailStop 1034, Kansas City, KS 66160, USA. Electronic address:

Myofascial pain and myofascial pain syndromes are among some of the most common acute and chronic pain conditions. Many interventional procedures can be performed in both an acute and chronic pain setting to address myofascial pain syndromes. Trigger point injections can be performed with or without imaging guidance such as fluoroscopy and ultrasound; however, the use of imaging in years past has been recommended to improve patient outcome and safety. Read More

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Ultrasound-Guided Gluteal Fascial Plane Block for the Treatment of Chronic Refractory Greater Trochanteric Pain Syndrome-Technique Description and Anatomical Correlation Study.

Pain Med 2022 May 2. Epub 2022 May 2.

Division of Anatomy, Department of Surgery, University of Toronto, . Toronto, Ontario, Canada.

Introduction: Greater trochanteric pain syndrome may often mimic pain generated from other sources. However, it is most commonly caused by gluteus medius and gluteus minimus tendinopathy or tear. The purpose of this technical report was to: 1) describe the ultrasound-guided fascial plane block technique targeting the superior gluteal nerve in the plane between gluteus medius/gluteus minimus to treat moderate-to-severe chronic refractory greater trochanteric pain syndrome; 2) anatomically correlate the procedure with cadaveric dissections demonstrating the structures being imaged and the tissues along the needle trajectory; 3) demonstrate the feasibility of the technique with serial dissection of one cadaveric specimen following injection with color dye. Read More

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A Novel Piriformis Injection Technique Utilizing Combined Fluoroscopy and Ultrasound - A Pilot Study.

Pain Physician 2022 03;25(2):E365-E374

Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR.

Background: Piriformis syndrome is a constellation of symptoms associated with low back, gluteal, and sciatic pain. One treatment for piriformis syndrome is the injection of local anesthetic, steroid, or botulinum toxin into the piriformis muscle. Various approaches for needle navigation into the piriformis muscle have been described using fluoroscopy or ultrasound. Read More

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Hydroxyapatite crystal deposition disease around the hip: a rare cause of piriformis syndrome and ischiofemoral impingement.

BJR Case Rep 2022 Mar 9;7(6):20210075. Epub 2022 Mar 9.

Department of Radiology, London North West University Healthcare NHS Trust, London, United Kingdom.

Hydroxyapatite crystal deposition disease (HADD) around the hip is typically described involving the gluteal tendons. However, HADD can occur in any location and result in varied clinical presentations. Even with small deposits, symptoms can be significant and imaging findings may appear aggressive, mimicking infection and malignancy particularly when in an atypical location. Read More

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Effectiveness of Hydro-Dissection of the Piriformis Muscle Plus Low-Dose Local Anesthetic Injection for Piriformis Syndrome: A Report of 2 Cases.

Am J Case Rep 2022 Feb 6;23:e935346. Epub 2022 Feb 6.

Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Japan.

BACKGROUND Piriformis syndrome causes severe buttock and low back pain and numbness of the lower limbs, leading to difficulty in walking. The lack of unified diagnostic criteria for piriformis syndrome until 2018 made it difficult to diagnose; therefore, it is often underestimated, and some patients do not receive appropriate treatment. Treatment methods include local anesthetic injection, steroid injection, and local botulinum toxin injection. Read More

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February 2022

Piriformis syndrome: muscle thickness or volume does not correlate with response to CT-guided injection.

Skeletal Radiol 2022 Jul 18;51(7):1407-1414. Epub 2021 Dec 18.

UT Southwestern Medical Center, Dallas, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.

Objective: To determine whether size of the piriformis muscle, as characterized by either the coronal width or a segmented volume, correlates with outcomes after CT-guided injections.

Materials And Methods: A consecutive series of 81 patients with piriformis syndrome received CT-guided injections of the sciatic nerve and piriformis muscle. Volume and thickness measurements of the piriformis were taken from T1W and T2W pre-injection images by two readers. Read More

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Report of a Novel Bilateral Variation of Sciatic and Inferior Gluteal Nerve: A Case Study.

Basic Clin Neurosci 2021 May-Jun;12(3):421-426. Epub 2021 May 1.

Department of Anatomical Sciences, Cellular and Molecular Research Center, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

Introduction: The sciatic nerve is the thickest nerve of the sacral plexus which innervates many muscles and vast areas of the skin of the lower limb. It leaves the pelvis via the greater sciatic foramen, emerges into the gluteal region by passing under the piriformis muscle, and descends beneath the gluteus maximus to divide into its terminal branches; the tibial and common peroneal nerve at the superior angle of the popliteal fossa. In some cases, the sciatic nerve divides into the tibial and common peroneal nerves at a higher level and one of them or both passes through or over the piriformis muscle. Read More

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Piriformis Syndrome Masquerading as an Ischiofemoral Impingement.

Cureus 2021 Sep 16;13(9):e18023. Epub 2021 Sep 16.

Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, USA.

Hip pain can have a number of different etiologies. Ischiofemoral impingement (IFI), an etiology causing extra-articular hip pain, shares many of the same symptoms as other causes of gluteal or inguinal pain, making its diagnosis difficult. We present a case of a young female with persistent deep gluteal pain who was diagnosed with IFI based on radiographic findings; however, a diagnostic injection into the quadratus femoris did not confirm IFI as the primary pain generator. Read More

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September 2021

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part VII, nerves of the lower limb.

Eur Radiol 2022 Mar 28;32(3):1456-1464. Epub 2021 Sep 28.

Oxford Musculoskeletal Radiology, Oxford, UK.

Objectives: To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton's neuroma) and provide clinical indications.

Methods: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton's neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Read More

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Effects of ultrasound-guided platelet rich plasma injection in patients with piriformis syndrome.

J Back Musculoskelet Rehabil 2022 ;35(3):633-639

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey.

Background: Piriformis syndrome (PS) is the common entrapment neuropathy causing buttock pain. Patients are conventionally treated with lifestyle modification, exercise, non-steroidal anti-inflammatory drugs, corticosteroid or botulinum toxin injections. However, some patients may not respond to these conventional treatment methods. Read More

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Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review.

Anesth Pain Med 2021 Feb 2;11(1):e112825. Epub 2021 Feb 2.

Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, USA.

Context: Piriformis syndrome is a solely clinical diagnosis that often eludes the practitioner and goes underdiagnosed. PS is a pain syndrome and for those it affects, causes persistent pain and limits daily activity and work capacity. It is a form of deep gluteal syndrome that needs to be considered on the differential of low back pain as it comprises between 0. Read More

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February 2021

Deep Gluteal Syndrome: A Pain in the Buttock.

Curr Sports Med Rep 2021 Jun;20(6):279-285

Abstract: While buttock pain is a common complaint in sports medicine, deep gluteal syndrome (DGS) is a rare entity. DGS has been proposed as a unifying term referring to symptoms attributed to the various pain generators located in this region. While not all-inclusive, the diagnosis of DGS allows for focus on pathology of regionally associated muscles, tendons, and nerves in the clinical evaluation and management of posterior hip and buttock complaints. Read More

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Bifurcation of the sciatic nerve: A descriptive study on a South African cadaver cohort.

Morphologie 2021 May 26. Epub 2021 May 26.

Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa. Electronic address:

Background: The sciatic nerve bifurcates into the tibial and common fibular nerves in six different regions: the pelvic region, gluteal region, proximal, middle, or distal third of the posterior thigh, or in the popliteal fossa. Inadequate knowledge of sciatic nerve anatomy could lead to failed nerve blocks, and damage during intramuscular injections. Limited studies have been done on African population groups and lack a quantifiable method to classify the levels of sciatic nerve bifurcation. Read More

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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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October 2021

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 2021 Oct 31;34(7):1028-1034. Epub 2020 Dec 31.

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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October 2021

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].

Authors:
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