Hip & pelvis

  • 제35권1호
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  • Pages.1-5
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  • 2023
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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Looking beyond Piriformis Syndrome: Is It Really the Piriformis?

  • Shivam Sharma (Department of Physical and Rehabilitation Medicine, Physiotherapy Section, Post Graduate Institute of Medical Education and Research) ;
  • Harmanpreet Kaur (Department of Physical and Rehabilitation Medicine, Physiotherapy Section, Post Graduate Institute of Medical Education and Research) ;
  • Nishank Verma (Department of Physical and Rehabilitation Medicine, Physiotherapy Section, Post Graduate Institute of Medical Education and Research) ;
  • Bibek Adhya (Department of Physical and Rehabilitation Medicine, Physiotherapy Section, Post Graduate Institute of Medical Education and Research)
  • 투고 : 2022.07.05
  • 심사 : 2022.11.09
  • 발행 : 2023.03.31
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초록

Piriformis syndrome is a common differential diagnosis related to sciatica. The following review provides a concise synopsis of the diagnosis, management, history, and alternatives to diagnosis of piriformis syndrome. A search of the literature for research articles related to piriformis syndrome and associated differential diagnosis of sciatica was conducted. A thorough review of the included articles found that the condition known as piriformis syndrome is over-diagnosed and that potential anatomic and biomechanical variations originating in the pelvic region might be related to the complaint of sciatica. The criteria for diagnosis are based on findings from both physical examination and radio imaging. Piriformis syndrome resembles a variety of clinical conditions; therefore, conduct of future studies should include development of a validated method for evaluation as well as clinical criteria for diagnosis of piriformis syndrome.

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참고문헌

  1. Gulledge BM, Marcellin-Little DJ, Levine D, et al. Comparison of two stretching methods and optimization of stretching protocol for the piriformis muscle. Med Eng Phys. 2014;36:212-8. https://doi.org/10.1016/j.medengphy.2013.10.016
  2. Robinson DR. Pyriformis syndrome in relation to sciatic pain. Am J Surg. 1947;73:355-8. https://doi.org/10.1016/0002-9610(47)90345-0
  3. Hopayian K, Song F, Riera R, Sambandan S. The clinical features of the piriformis syndrome: a systematic review. Eur Spine J. 2010;19:2095-109. https://doi.org/10.1007/s00586-010-1504-9
  4. Vas L, Pai R, Pawar KS, Pattnaik M. "Piriformis syndrome": is it only piriformis? Pain Med. 2016;17:1775-9. https://doi.org/10.1093/pm/pnw037
  5. Hicks BL, Lam JC, Varacallo M. Piriformis syndrome. Treasure Island: StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK448172/
  6. McCrory P. The "piriformis syndrome"--myth or reality? Br J Sports Med. 2001;35:209-10. Retraction in: Br J Sports Med. 2022;bjsm.35.4.209-aret. https://doi.org/10.1136/bjsm.35.4.209-a
  7. Malloy PJ, Morgan AM, Meinerz CM, Geiser CF, Kipp K. Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res. 2016;30:282-91. https://doi.org/10.1519/JSC.0000000000001069
  8. Menu P, Fouasson-Chaillou A, Dubois C, Dauty M. Piriformis syndrome diagnosis: on two professional cyclists. Ann Phys Rehabil Med. 2014;57:268-74. https://doi.org/10.1016/j.rehab.2014.02.006
  9. Miller TA, White KP, Ross DC. The diagnosis and management of Piriformis Syndrome: myths and facts. Can J Neurol Sci. 2012;39:577-83. https://doi.org/10.1017/s0317167100015298
  10. Jeong HS, Lee GY, Lee EG, Joe EG, Lee JW, Kang HS. Long-term assessment of clinical outcomes of ultrasound-guided steroid injections in patients with piriformis syndrome. Ultrasonography. 2015;34:206-10. https://doi.org/10.14366/usg.14039
  11. Santamato A, Micello MF, Valeno G, et al. Ultrasound-guided injection of botulinum toxin type A for piriformis muscle syndrome: a case report and review of the literature. Toxins (Basel). 2015;7:3045-56. https://doi.org/10.3390/toxins7083045
  12. Hogan E, Vora D, Sherman JH. A minimally invasive surgical approach for the treatment of piriformis syndrome: a case series. Chin Neurosurg J. 2020;6:8. https://doi.org/10.1186/s41016-020-00189-y
  13. Fusco P, Di Carlo S, Scimia P, Degan G, Petrucci E, Marinangeli F. Ultrasound-guided dry needling treatment of myofascial trigger points for piriformis syndrome management: a case series. J Chiropr Med. 2018;17:198-200. https://doi.org/10.1016/j.jcm.2018.04.002
  14. Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. J Orthop Sports Phys Ther. 2010;40:103-11. https://doi.org/10.2519/jospt.2010.3108
  15. Jawish RM, Assoum HA, Khamis CF. Anatomical, clinical and electrical observations in piriformis syndrome. J Orthop Surg Res. 2010;5:3. https://doi.org/10.1186/1749-799X-5-3
  16. Michel F, Decavel P, Toussirot E, et al. The piriformis muscle syndrome: an exploration of anatomical context, pathophysiological hypotheses and diagnostic criteria. Ann Phys Rehabil Med. 2013;56:300-11. https://doi.org/10.1016/j.rehab.2013.03.006
  17. Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med. 1934;211:210-5. https://doi.org/10.1056/NEJM193408022110506
  18. Filler AG, Haynes J, Jordan SE, et al. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine. 2005;2:99-115. https://doi.org/10.3171/spi.2005.2.2.0099
  19. Fishman LM, Zybert PA. Electrophysiologic evidence of piriformis syndrome. Arch Phys Med Rehabil. 1992;73:359-64. https://doi.org/10.1016/0003-9993(92)90010-t
  20. Tiel RL. Piriformis and related entrapment syndromes: myth & fallacy. Neurosurg Clin N Am. 2008;19:623-7, vii. https://doi.org/10.1016/j.nec.2008.07.028
  21. Meknas K, Christensen A, Johansen O. The internal obturator muscle may cause sciatic pain. Pain. 2003;104:375-80. https://doi.org/10.1016/s0304-3959(03)00045-9
  22. Fuller G. Focal peripheral neuropathies. J Neurol Neurosurg Psychiatry. 2003;74(Suppl 2):ii20-4. https://doi.org/10.1136/jnnp.74.suppl_2.ii20
  23. Siddiq MAB, Jahan I, Masihuzzaman S. Wallet neuritis- an example of peripheral sensitization. Curr Rheumatol Rev. 2018;14:279-83. https://doi.org/10.2174/1573397113666170310100851
  24. Puranen J, Orava S. The hamstring syndrome--a new gluteal sciatica. Ann Chir Gynaecol. 1991;80:212-4.
  25. Smoll NR. Variations of the piriformis and sciatic nerve with clinical consequence: a review. Clin Anat. 2010;23:8-17. https://doi.org/10.1002/ca.20893
  26. Sen A, Rajesh S. Accessory piriformis muscle: an easily identifiable cause of piriformis syndrome on magnetic resonance imaging. Neurol India. 2011;59:769-71. https://doi.org/10.4103/0028-3886.86562
  27. Stewart JD. The piriformis syndrome is overdiagnosed. Muscle Nerve. 2003;28:644-6. https://doi.org/10.1002/mus.10483
  28. Barbosa ABM, Santos PVD, Targino VA, et al. Sciatic nerve and its variations: is it possible to associate them with piriformis syndrome? Arq Neuropsiquiatr. 2019;77:646-53. https://doi.org/10.1590/0004-282X20190093
  29. Berihu BA, Debeb YG. Anatomical variation in bifurcation and trifurcations of sciatic nerve and its clinical implications: in selected university in Ethiopia. BMC Res Notes. 2015;8:633. https://doi.org/10.1186/s13104-015-1626-6
  30. Bartret AL, Beaulieu CF, Lutz AM. Is it painful to be different? Sciatic nerve anatomical variants on MRI and their relationship to piriformis syndrome. Eur Radiol. 2018;28:4681-6. https://doi.org/10.1007/s00330-018-5447-6
  31. Siahaan YMT, Tiffani P, Tanasia A. Ultrasound-guided measurement of piriformis muscle thickness to diagnose piriformis syndrome. Front Neurol. 2021;12:721966. https://doi.org/10.3389/fneur.2021.721966
  32. Lee EY, Margherita AJ, Gierada DS, Narra VR. MRI of piriformis syndrome. AJR Am J Roentgenol. 2004;183:63-4. https://doi.org/10.2214/ajr.183.1.1830063
  33. Justice PE, Katirji B, Preston DC, Grossman GE. Piriformis syndrome surgery causing severe sciatic nerve injury. J Clin Neuromuscul Dis. 2012;14:45-7. https://doi.org/10.1097/CND.0b013e318259617c
  34. Hwang DS, Noh CK. Comprehensive review of advancements in hip arthroscopy. Hip Pelvis. 2017;29:15-23. https://doi.org/10.5371/hp.2017.29.1.15
  35. Han SK, Kim YS, Kim TH, Kang SH. Surgical treatment of piriformis syndrome. Clin Orthop Surg. 2017;9:136-44. https://doi.org/10.4055/cios.2017.9.2.136