Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome

Pećina, Hrvoje Ivan; Borić, Igor; Smoljanović, Tomislav; Duvancic, Davor; Pećina, Marko

doi:10.1007/s00256-008-0538-0

Cited by 47 publications

(24 citation statements)

References 15 publications

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“…While the cases reported in the past have suffered from none contribution of the modern imaging, the use of MRI has become essential to rule out any spinal disorders or pelvic disorders as mentioned by Pecina [14] who found an MRI abnormality for the piriformis muscle syndrome in 7 out of his 10 patients; it is in practice the first exam that evokes the piriformis muscle, particularly in patient with chronic sciatica. However, and apart from the MR neurography or piriformis blocks [15,16] in which we have no experience, the MRI of pelvis remains unable to define a criteria for diagnosis, since the asymmetrical size of the Piriformis muscle observed in our cases, is common in normal people and identified in T1-weighted MRI of the pelvis performed for 100 persons [17].…”

Section: Discussionmentioning

confidence: 99%

Anatomical, Clinical and Electrical Observations in Piriformis Syndrome

Jawish

Assoum²,

Khamis³

2010

J Orthop Surg Res

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BackgroundWe provided clinical and electrical descriptions of the piriformis syndrome, contributing to better understanding of the pathogenesis and further diagnostic criteria.MethodsBetween 3550 patients complaining of sciatica, we concluded 26 cases of piriformis syndrome, 15 females, 11 males, mean age 35.37 year-old. We operated 9 patients, 2 to 19 years after the onset of symptoms, 5 had piriformis steroids injection. A dorsolumbar MRI were performed in all cases and a pelvic MRI in 7 patients. The electro-diagnostic test was performed in 13 cases, between them the H reflex of the peroneal nerve was tested 7 times.ResultsAfter a followup 1 to 11 years, for the 17 non operated patients, 3 patients responded to conservative treatment. 6 of the operated had an excellent result, 2 residual minor pain and one failed. 3 new anatomical observations were described with atypical compression of the sciatic nerve by the piriformis muscle.ConclusionWhile the H reflex test of the tibial nerve did not give common satisfaction in the literature for diagnosis, the H reflex of the peroneal nerve should be given more importance, because it demonstrated in our study more specific sign, with six clinical criteria it contributed to improve the method of diagnosis. The cause of this particular syndrome does not only depend on the relation sciatic nerve-piriformis muscle, but the environmental conditions should be considered with the series of the anatomical anomalies to explain the real cause of this pain.

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Section: Discussionmentioning

confidence: 99%

Anatomical, Clinical and Electrical Observations in Piriformis Syndrome

Jawish

Assoum²,

Khamis³

2010

J Orthop Surg Res

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“…Aynı tarafta kas hipertrofisi ve sinir ödeminin birlikte izlenmesi durumda, özgül-lük %93 düzeyine çıkmaktadır. [13] …”

Section: Derin Peroneal Sinir (şEkil 11)unclassified

Tuzak nöropatilerde manyetik rezonans görüntüleme

Yörübulut¹

2015

TOTBID

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MR görüntüleme (konvansiyonel MR ve MR nö-rografi), basıya uğrayan sinirin morfolojisinde ortaya çıkan değişiklikleri ayrıntılı olarak gösterebildiği gibi, bu yöntemle basıyı oluşturan etmen ortaya konulur; ayrıca, çevre yumuşak ve kemik dokular hakkında da yeterli düzeyde bilgi verir. MR görüntüleme ile, sinirin innerve ettiği kasta denervasyon sonucunda oluşan akut ve kronik değişiklikler de izlenir. Akut fazda, kas ödemi, denervasyondan yaklaşık 24-48 saat sonra ortaya çıkar. Kasta yağlı atrofi ise, kronik denervasyon bulgusudur ve denervasyondan birkaç ay sonra ortaya çıkmaktadır. [2][3] MR görüntüleme, invaziv olmayan bir inceleme tekniği olup, radyasyon içermez. Uzaysal çözünürlüğü yüksek olup, multiplanar görüntüleme yapılabilir. Tanı ve ayırıcı tanının yanı sıra, tedavinin medikal, girişimsel (enjeksiyon-blok) veya cerrahi olmasını büyük oranda etkiler. Ayrıca, cerrahi tedavi sonrasında oluşabilecek T uzak nöropatiler, periferik sinirlerin anatomik gidiş yolları boyunca, çoğunlukla fibröz-fibroosseöz tünelleri geçişleri esnasında mekanik olarak basıya maruz kalmaları sonucunda oluşan nöropatilerdir. Daha nadir olarak, bu tür nöropatiler, sinire direkt bası olmadan, hareketler esnasında dinamik şekilde de oluşabilir. Klinik tablo, basıya uğrayan sinire bağlı olarak ortaya çıkar ve tuzak nöropatiler, vü-cudun herhangi bir anatomik bölgesinde görülebilir.[1] RADYOLOJİK TANITuzak nöropatilerde, tanı için radyolojik görüntüle-me yöntemleri, manyetik rezonans (MR) görüntüleme, ultrasonografi, röntgen ve bigisayarlı tomografi incelemeleridir. Son iki yöntem radyasyon içerirken, daha çok basıya neden olan osseöz-kalsifiye yapıların görün-tülemesinde ve nadiren ayırıcı tanı için kullanılır. Tuzak nöropatilerde manyetik rezonans görüntüleme

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“…Piriformis syndrome is a controversial diagnosis, often thought to be related to sciatic nerve compression or irritation related to the piriformis muscle. MRI can show variations in anatomy, muscle hypertrophy, as well as abnormal signal of the sciatic nerve [19]. MR imaging is not only a sensitive technique in identifying and characterizing the causative abnormalities but also can provide useful information for surgical planning [20].…”

Section: Lower Limbmentioning

confidence: 99%

Entrapment Neuropathies in the Upper and Lower Limbs: Anatomy and MRI Features

Dong

Jacobson

Jamadar

et al. 2012

Radiology Research and Practice

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Peripheral nerve entrapment occurs at specific anatomic locations. Familiarity with the anatomy and the magnetic resonance imaging (MRI) features of nerve entrapment syndromes is important for accurate diagnosis and early treatment of entrapment neuropathies. The purpose of this paper is to illustrate the normal anatomy of peripheral nerves in the upper and lower limbs and to review the MRI features of common disorders affecting the peripheral nerves, both compressive/entrapment and noncompressive, involving the suprascapular nerve, the axillary nerve, the radial nerve, the ulnar nerve, and the median verve in the upper limb and the sciatic nerve, the common peroneal nerve, the tibial nerve, and the interdigital nerves in the lower limb.

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Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome

Cited by 47 publications

References 15 publications

Anatomical, Clinical and Electrical Observations in Piriformis Syndrome

Anatomical, Clinical and Electrical Observations in Piriformis Syndrome

Tuzak nöropatilerde manyetik rezonans görüntüleme

Entrapment Neuropathies in the Upper and Lower Limbs: Anatomy and MRI Features

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