Piriformis Injection: An Ultrasound-Guided Technique

Bardowski, Elizabeth A.; Byrd, J. W. Thomas

doi:10.1016/j.eats.2019.07.033

Cited by 13 publications

(12 citation statements)

References 5 publications

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“…It has been estimated that approximately 5-10% of patients with lower back pain have sciatica. The underlying conditions typically resulting in sciatic neuritis in humans include lumbosacral diseases, tumors compressing the sciatic nerve, and deep gluteal syndrome (DGS) or piriformis syndrome (1)(2)(3)(4)(5)(6). Degenerative disc disease or lumbar disc herniation (LDH) compressing the lumbosacral nerve roots is the most common cause of sciatic nerve irritation (2).…”

Section: Introductionmentioning

confidence: 99%

“…Degenerative disc disease or lumbar disc herniation (LDH) compressing the lumbosacral nerve roots is the most common cause of sciatic nerve irritation (2). Approximately 5% of sciatic cases in humans are extraspinal in origin (1). Deep gluteal syndrome (DGS) is an entity characterized by pain in the buttock area, hip, or posterior thigh and/or radicular pain due to non-discogenic sciatic nerve entrapment in the subgluteal space.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis

Toijala¹,

Canapp²,

Canapp³

2021

Front. Vet. Sci.

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The present study aimed to describe the ultrasonography technique and analyze the ultrasonographic findings of the proximal sciatic nerve and deep gluteal muscles in dogs with suspected sciatic neuritis. The records of 29 dogs that underwent musculoskeletal ultrasound of the sciatic nerve and deep gluteal muscles were retrospectively evaluated. Both right and left sides were evaluated. Abnormal findings were unilateral in 28/29 (97%) of the dogs. The muscles examined included the piriformis muscle, gemelli muscles, internal obturator muscle, and medial gluteal muscle. Data included signalment, purpose of the dog, orthopedic examination findings, lameness examination findings, other diagnostic imaging findings, and ultrasonography findings. Irregular margins of the sciatic nerve were recorded in 76% of the dogs. The diameter of the sciatic nerve on the affected limb was significantly larger than the nerve on the contralateral, unaffected side (p < 0.00001). The mean ± standard deviation (SD) of the sciatic nerve inner diameter between the unaffected and affected limbs was 15 ± 14.66%. The mean ± SD in sciatic nerve outer diameter was 12 ± 7.71%. Abnormal ultrasonographic findings in at least one of the examined muscles were found in 28/29 (97%) of the dogs and included changes in echogenicity in 28/29 (97%) of the dogs, loss of detail in muscle fiber pattern in 5/29 (17%) of the dogs, and impingement between the sciatic nerve and piriformis muscle in 6/29 (21%) of the dogs. The most common underlying diagnosis was lumbosacral stenosis in 9/29 (31%) of the dogs. The most common sport was agility for 21/29 (71%) of the dogs. Repetitive jumping may predispose to both lumbosacral disease, through dynamic compression, and changes within the piriformis muscle, due to overuse of the muscle leading to irritation to sciatic nerve. Ultrasonography is considered a safe and non-invasive diagnostic method to evaluate the sciatic nerve and deep gluteal muscles of dogs, and provides additional guidance for diagnostics and rehabilitation planning. This is the first study documenting ultrasonography findings in a case series of the sciatic nerve and deep gluteal muscles and their pathology in dogs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis

Toijala¹,

Canapp²,

Canapp³

2021

Front. Vet. Sci.

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“…the piriformis syndrome) (24) . The estimated prevalence of the piriformis syndrome and absence of ionizing radiation (27,31) . Piriformis muscle enlargement may be seen in patients with piriformis syndrome (22,(32)(33)(34) .…”

Section: Piriformis Syndromementioning

confidence: 99%

“…The schiatic nerve and the piriformis muscle are well depicted with US; an important prerequisite for image-guided treatment ( 28 – 30 ) . US guidance is preferable to other image-guided modalities due to its simplicity, reliability, and absence of ionizing radiation ( 27 , 31 ) . Piriformis muscle enlargement may be seen in patients with piriformis syndrome ( 22 , 32 – 34 ) .…”

Section: Piriformis Syndromementioning

confidence: 99%

Ultrasound-guided injections in pelvic entrapment neuropathies

et al. 2021

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Pelvic entrapment neuropathies represent a group of chronic pain syndromes that significantly impede the quality of life. Peripheral nerve entrapment occurs at specific anatomic locations. There are several causes of pelvic entrapment neuropathies, such as intrinsic nerve abnormality or inflammation with scarring of surrounding tissues, and surgical interventions in the abdomen, pelvis and the lower limbs. Entrapment neuropathies in the pelvic region are not widely recognized, and still tend to be underdiagnosed due to numerous differential diagnoses with overlapping symptoms. However, it is important that entrapment neuropathies are correctly diagnosed, as they can be successfully treated. The lateral femoral cutaneous nerve, ischiadic nerve, genitofemoral nerve, pudendal nerve, ilioinguinal nerve and obturator nerve are the nerves most frequently causing entrapment neuropathies in the pelvic region. Understanding the anatomy as well as nerve motor and sensory functions is essential in recognizing and locating nerve entrapment. The cornerstone of the diagnostic work-up is careful physical examination. Different imaging modalities play an important role in the diagnostic process. Ultrasound is a key modality in the diagnostic work-up of pelvic entraptment neuropathies, and its use has become increasingly widespread in therapeutic procedures. In the article, the authors describe the background of pelvic entrapment neuropathies with special focus on ultrasound-guided injections.

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“…Keseluruhan modalitas tidak selalu dilakukan secara berurutan, tetapi bergantung pada kondisi yang dihadapi pasien seperti intensitas nyeri berat, dampak sosial dan pekerjaan yang terganggu, ataupun penolakan pasien terhadap modalitas terapi tertentu. 7,13 Dalam lingkup pengetahuan penulis, hingga saat ini belum ada penelitian yang menunjukkan efektivitas suatu modalitas terapi yang lebih superior dibandingkan dengan terapi lainnya. Hal ini mengakibatkan pemilihan terapi seringkali bergantung pada pengalaman klinisi dalam mengobati pasien SP.…”

Section: Pembahasanunclassified

Penggunaan Toksin Botulinum-a Dengan Panduan Ultrasonografi Sebagai Terapi Sindrom Piriformis Rekuren: Serial Kasus

Siahaan¹

2020

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Sindrom piriformis (SP) merupakan sindrom klinis dengan keluhan nyeri pantat menjalar ke tungkai sisi unilateral yang disebabkan penekanan saraf skiatik oleh otot piriformis. Beberapa modalitas terapi SP antaralain terapi oral, fisik, intervensi hingga pembedahan. Terapi injeksi intramuskular merupakan terapi intervensi bagi pasien yang mengalami nyeri hebat atau mengalami kegagalan terapi oral dan/atau terapi fisik. Terapi injeksi intramuskular umumnya berupa penggunaan anestesi lokal, kortikosteroid maupun toksin Botulinum A. Studi ini mewakili lima kasus SP yang mengalami kekambuhan dalam periode singkat pada 4 perempuan dan 1 laki-laki dengan variasi usia 32-43 tahun. Keseluruhan kasus mengeluhkan gejala klasik dengan onset subakut-kronik juga riwayat pengobatan konservatif dan intervensi. Perbaikan jangka panjang (>9 bulan) dialami pascainjeksi toksin-botulinum-A dengan panduan ultrasonografi. Kata Kunci: Sindrom piriformis, terapi injeksi, toksin botulinum

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Piriformis Injection: An Ultrasound-Guided Technique

Cited by 13 publications

References 5 publications

Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis

Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis

Ultrasound-guided injections in pelvic entrapment neuropathies

Penggunaan Toksin Botulinum-a Dengan Panduan Ultrasonografi Sebagai Terapi Sindrom Piriformis Rekuren: Serial Kasus

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