Anatomical variation of piriformis muscle as a cause of deep gluteal pain: diagnosis using MR neurography and treatment

Polesello, Giancarlo Cavalli; Queiroz, Marcelo Cavalheiro de; Linhares, João Paulo Tavares; Amaral, Denise Tokechi; Ono, Nelson Keiske

doi:10.1016/j.rboe.2012.09.001

Cited by 11 publications

(15 citation statements)

References 11 publications

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“…Belly of the accessory muscle was thick and mostly tendinous. Direction of the fibers was not similar to the proper muscle which makes the case different from previously reported muscle slips, double or three-bellied variations 4,6,9 . Piriformis syndrome is one of the extra-spinal causes of sciatica.…”

Section: Discussioncontrasting

confidence: 93%

Aksesuar musculus piriformis

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et al. 2017

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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Piriformis muscle originates from facies pelvica of sacrum and inserts on the trochanter major. It is one of the lateral rotator muscles of the hip and a landmark point in the gluteal region since ischiadicus nerve descends to the thigh by passing close to the muscle. This contiguity may be associated with the irritation of the nerve which is known as piriformis syndrome. A rare anatomic variation of the muscle which observed on 74 years old male cadaver is discussed in this case report. Piriformis kası os sacrum'un facies pelvica'sından başlar ve trochanter major'a insersiyo yapar. Kalçanın dış rotator kaslarından birisidir ve nervus ischiadicus kasın yakın komşuluğundan geçip uyluğa doğru seyrettiği için gluteal bölgede bir işaret noktasıdır. Bu komşuluk, piriformis sendromu olarak da bilinen sinirin irritasyonu ile ilişkili olabilir. Bu olguda, kasın 74 yaşındaki bir erkek kadavrada gözlenen nadir bir anatomik varyasyonu tartışılmıştır.

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Section: Discussioncontrasting

confidence: 93%

Aksesuar musculus piriformis

Develı

Yıldırım

Yalçın

et al. 2017

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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“…Despite treatment with physiotherapy, analgesics, and an L5-S1 arthrodesis, the patient's pain became progressively worse, preventing her from work. 37 Five subsequent MRI examinations revealed no abnormal findings in the lumbosacral spine and left hip. 37 MRN over the left hip region eventually revealed an accessory muscle belly of the left piriformis with the fibular branch of the sciatic nerve passing between the fibers of this accessory belly and the standard piriformis muscle.…”

Section: Lower Extremity Neuropathymentioning

confidence: 89%

“…37 Five subsequent MRI examinations revealed no abnormal findings in the lumbosacral spine and left hip. 37 MRN over the left hip region eventually revealed an accessory muscle belly of the left piriformis with the fibular branch of the sciatic nerve passing between the fibers of this accessory belly and the standard piriformis muscle. 37 In this case, MRN provided a definitive diagnosis regarding the etiology of the patient's pain, which subsequently allowed accurate presurgical planning for endoscopic release of the piriformis.…”

Section: Lower Extremity Neuropathymentioning

confidence: 89%

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

Cox

Mikeska

2021

J Brachial Plex Peripher Nerve Inj

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Peripheral nerve injuries (PNIs) continue to present both diagnostic and treatment challenges. While nerve transections are typically a straightforward diagnosis, other types of PNIs, such as chronic or traumatic nerve compression, may be more difficult to evaluate due to their varied presentation and limitations of current diagnostic tools. As a result, diagnosis may be delayed, and these patients may go on to develop progressive symptoms, impeding normal activity. In the past, PNIs were diagnosed by history and clinical examination alone or techniques that raised concerns regarding accuracy, invasiveness, or operator dependency. Magnetic resonance neurography (MRN) has been increasingly utilized in clinical settings due to its ability to visualize complex nerve structures along their entire pathway and distinguish nerves from surrounding vasculature and tissue in a noninvasive manner. In this review, we discuss the clinical applications of MRN in the diagnosis, as well as pre- and postsurgical assessments of patients with peripheral neuropathies.

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“…No obstante, Kirschner et al (2009) han señalado que no está claro que estas variaciones anatómicas sean las responsables o contribuyan a esta patología, debido a que algunos pacientes asintomáticos presentan estas variaciones y algunos sintomáticos no las presentan. Muñoz (2004), Polesello et al (2013) y Kraus et al (2016) a través de resonancia nuclear magnética evidenciaron casos de pacientes que sufrían del síndrome del músculo piriforme, en el mismo lugar donde se observaba hipertrofia del músculo piriforme.…”

Section: Discussionunclassified

Reporte de Caso: Origen del Músculo Piriforme a Través de Dos Cabezas en Forma de Bíceps, Propicia División del Nervio Isquiático en Nervio Fibular Común y Nervio Tibial

2020

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RESUMEN: El músculo piriforme es un músculo pelvitrocantérico que recibe su nombre debido a su forma de pera, cuyo origen es de varios fascículos que se encuentran entre los forámenes anteriores del sacro, correspondiente a las segunda, tercera y cuarta vértebra. Estos fascículos se funden constituyendo un músculo aplanado, que se inserta en el trocánter mayor del fémur. Presenta una relación bien conocida con el nervio isquiático, el cual comúnmente emerge hacia la región glútea por el margen inferior de este músculo, sin embargo a través del tiempo, autores han descrito variaciones del paso de este nervio que podrían asociarse a alguna patología de compresión del nervio isquiático. En una disección rutinaria de dos individuos formolizados, uno femenino y otro masculino de la región glútea, encontramos que el músculo piriforme se originaba a través de dos cabezas, cada una con su propia fascia que se unían en un vientre común, en forma de bíceps y a través de un tendón cilíndrico se insertaban en la parte medial del trocánter mayor del fémur. El nervio isquiático se encontraba dividido, el nervio fibular común emergía a la región glútea a través de las cabezas, en tanto el nervio tibial por el margen inferior del músculo piriforme. Es importante comunicar las variaciones anatómicas para complementar el conocimiento de las mismas, las que pueden explicar ciertos trastornos físicos y dolorosos como el denominado síndrome del músculo piriforme.

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Anatomical variation of piriformis muscle as a cause of deep gluteal pain: diagnosis using MR neurography and treatment

Cited by 11 publications

References 11 publications

Aksesuar musculus piriformis

Aksesuar musculus piriformis

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

Reporte de Caso: Origen del Músculo Piriforme a Través de Dos Cabezas en Forma de Bíceps, Propicia División del Nervio Isquiático en Nervio Fibular Común y Nervio Tibial

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