Ultrasound-Guided Piriformis Injection: Technique Description and Verification

Smith, Jay; Hurdle, Mark Friedrich B.; Locketz, Adam J.; Wisniewski, Stephen J.

doi:10.1016/j.apmr.2006.08.337

Cited by 117 publications

(78 citation statements)

References 12 publications

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“…14,42 Involvement of the PM in sciatic neuropathy has been supported by evidence from computed tomography (CT), magnetic resonance imaging (MRI), 62,68,[80][81][82][83][84] scintigraphy, 85 and ultrasound. 36 Even so, if PS is suspected, a CT examination of the pelvis should certainly be conducted in order to detect side-to-side differences in the PM or other causes of the narrowing of the infrapiriform foramen. 26,86,87 If uncertainties remain, an MRI examination of the sciatic nerve and its vicinity -particularly with regard to structural changes in the PM -is indicated.…”

Section: Electrophysiological Testsmentioning

confidence: 99%

“…98 There have been many reports of ultrasound-guided PM injection that describe similar techniques with minor variation. 36,80,[98][99][100] The technique described below is the author's preferred technique. 28 …”

Section: Ultrasound-guided Injectionmentioning

confidence: 99%

“…7,32 The neuropathic component refers to the compression or irritation of the sciatic nerve as it courses through the infrapiriform foramen. 5,9,14,20,[33][34][35][36][37] In addition, irritation and compression of the neighbouring nerves and vessels (Figs. 1, 3A, 3D) can give rise to pain with a classic distribution pattern.…”

Section: Pathophysiology and Etiologymentioning

confidence: 99%

See 2 more Smart Citations

Brief review: Piriformis syndrome: etiology, diagnosis, and management

Jankovic¹,

Peng

Zundert

2013

Can J Anesth/J Can Anesth

124

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In this narrative review, we aim to provide the pathophysiology and diagnostic criteria of the piriformis syndrome (PS), an underdiagnosed cause of buttock and leg pain that can be difficult to treat. Based on existing evidence, frequencies of clinical features are estimated in patients reported to have PS. In view of the increasing popularity of ultrasound for intervention, the ultrasound-guided technique in the treatment of PS is described in detail. A literature search of the MEDLINEA (R) database was performed from January 1980 to December 2012 using the search terms e.g., " piriformis injection", " ultrasound guided piriformis injection", " botulinum toxin", "pain management", and different structures relevant in this review. There was no restriction on language. A review of the medical literature pertaining to PS revealed that the existence of this entity remains controversial. There is no definitive proof of its existence despite reported series with large numbers of patients. Piriformis syndrome continues to be a controversial diagnosis for sciatic pain. Electrophysiological testing and nerve blocks play important roles when the diagnosis is uncertain. Injection of local anesthetics, steroids, and botulinum toxin into the piriformis muscle can serve both diagnostic and therapeutic purposes. An ultrasound-guided injection technique offers improved accuracy in locating the piriformis muscle. Optimizing the therapeutic approach requires an interdisciplinary evaluation of treatment

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Section: Electrophysiological Testsmentioning

confidence: 99%

Section: Ultrasound-guided Injectionmentioning

confidence: 99%

Section: Pathophysiology and Etiologymentioning

confidence: 99%

See 1 more Smart Citation

Brief review: Piriformis syndrome: etiology, diagnosis, and management

Jankovic¹,

Peng

Zundert

2013

Can J Anesth/J Can Anesth

124

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“…Iliopsoas tendon and bursa [90] Intra-articular hip joint [91] Piriformis injection [92] Knee Intra-articular knee [93] Baker's cyst aspiration [94] Pes anserine bursa [95] Foot/ankle Subtalar/tibiotalar/sinus tarsi [96] Retrocalcaneal bursa [97] Plantar fascia [98] Metatarsophalangeal joint/sesamoid disorders [99] Interdigital neuroma [100] ongoing studies are needed to assess clinical efficacy, the role of ultrasound in the emerging field of bioregenerative medicine appears crucial.…”

Section: Hipmentioning

confidence: 99%

Musculoskeletal Ultrasound in Physical Medicine and Rehabilitation

Deimel

Jelsing

Hall

2013

Curr Phys Med Rehabil Rep

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“…Once you have pierced the gluteus maximus muscle, the piriformis muscle will lie just deep to this structure. Inject mixture of local anesthetic and steroid into the piriformis muscle [41].…”

Section: Ultrasound-guidedmentioning

confidence: 99%

Image-Guided Injections of the Hip

Singh¹

2014

J Nov Physiother Phys Rehabil

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The authors present a technique paper on the utilization of both ultrasound and fluoroscopy guidance for injections about the hip joint. This review draws from specialists including physiatry, family medicine and orthopaedic surgery. We hope the editors and reviewers find this document beneficial to the readership, especially those practicing musculoskeletal medicine and may use this information when performing hip injections.

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Ultrasound-Guided Piriformis Injection: Technique Description and Verification

Cited by 117 publications

References 12 publications

Brief review: Piriformis syndrome: etiology, diagnosis, and management

Brief review: Piriformis syndrome: etiology, diagnosis, and management

Musculoskeletal Ultrasound in Physical Medicine and Rehabilitation

Image-Guided Injections of the Hip

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