Accuracy of Ultrasound-Guided Versus Fluoroscopically Guided Contrast-Controlled Piriformis Injections

Finnoff, Jonathan T.; Hurdle, Mark Friedrich B.; Smith, Jay

doi:10.7863/jum.2008.27.8.1157

Cited by 96 publications

(77 citation statements)

References 12 publications

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“…A cadaver study showed that the accuracy of this method was only 30%, with most of the needle tip being positioned in the gluteus maximus muscle. 98 This is not surprising given the fact that the fluoroscopy technique does not allow direct visualization of the soft tissue. Ultrasound and computer tomography (CT) have the advantage of allowing direct visualization of the PM.…”

Section: Limitation Of the Current Techniquesmentioning

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%

“…The reliability of the ultrasoundguided method has been confirmed in a cadaver study. 98 Compared with a CT-guided technique, ultrasound is much more affordable and accessible. The ultrasound-guided technique also offers the additional advantages of avoiding radiation exposure and allowing real-time injection.…”

Section: Limitation Of the Current Techniquesmentioning

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

132

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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: Limitation Of the Current Techniquesmentioning

confidence: 99%

Section: Ultrasound-guided Injectionmentioning

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

132

View full text Add to dashboard Cite

show abstract

“…Siyatik sinir ile piriformis kasının anatomik ilişkisi ile ilgili varyasyonlar nedeniyle körleme yerine guideline eşliğinde enjeksiyonlar tercih edilmeye başlanmıştır. Ultrasonografi, BT, MRG, floroskopi ve EMG eşliğinde yapılan enjeksiyonların başarılı olduğuna dair çeşitli yayınlar mevcuttur [16][17][18][19] . Huerto ve ark.…”

Section: Tedaviunclassified

Piriformis Syndrome

Mesci¹

2017

Haydarpasa Numune Med J

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Piriformis sendromu (PS), siyatik sinirin piriformis kası tarafından tuzaklanması ile oluşan bir klinik tablodur. Siyatik sinir ile piriformis kasının anatomik ilişkisi ile ilgili çeşitli varyasyonlar görülebilir. Piriformis kası kalça eklemine uyluk ekstansiyondayken dış rotasyon, kalça fleksiyondayken abduksiyon yaptırır. Piriformis kasında miyofasial tetik nokta, hipertrofi, inflamasyon, travmatik yaralanmalar, piriformis kası ve/veya siyatik sinirin anatomik varyasyonları ve myositis ossifikans gibi nedenler PS'na yol açabilmektedir. Siyatik ağrısı vakalarının %5-6'sının PS olduğu gösterilmiştir. Ancak radiküler ağrı ile karıştığı için bu oranın daha fazla olduğu düşünülmektedir. Bu derlemede nondiskojenik siyatalji ayırıcı tanısında düşünülmesi gereken PS ve ultrasonografinin PS tanı ve tedavisindeki öneminden bahsedilmiştir. Anahtar sözcükler: Piriformis sendromu; siyatik sinir; ultrasonografi. Piriformis Syndrome AbstractPiriformis syndrome (PS) is a clinical picture that develops when the sciatic nerve is trapped by the piriformis muscle. Several variations in the anatomical relationship of the sciatic nerve and the piriformis muscle may be seen. The piriformis muscle externally rotates the hip joint when the thigh is in extension and abducts when the hip is in flexion. Myofascial trigger points in the piriformis muscle, hypertrophy, inflammation, traumatic injury, anatomical variations of the piriformis muscle and/or the sciatic nerve, and myositis ossificans can cause PS. It has been reported that 5% to 6% of sciatic pain cases are PS. However, it is thought that this percentage may actually be higher because it can be confused with radicular pain. PS should be considered in the diagnosis of nondiscogenic sciatica, and the importance of ultrasonography in the diagnosis and treatment of PS are described in this review.

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“…Other uses of ultrasound within CNS rehabilitation include neurotoxin injections for cervical dystonia, primary dystonia, and piriformis syndrome, as well as being an effective means to assess shoulder pathology in wheelchair users with spinal cord injury and early arthritic changes in patients with hemiparesis following stroke [57][58][59].…”

Section: Central Nervous System Rehabilitationmentioning

confidence: 99%