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Description

Piriformis syndrome has long been a diagnostic quandary due to its tendency to present as other nerve-related conditions. Piriformis syndrome is commonly caused by entrapment of the sciatic nerve as it travels through the greater sciatic foramen due to hypertrophy of the piriformis muscle. However, its constellation of symptoms, including radiating pain down the thigh, can easily be mistaken for lumbosacral radiculopathy. This case report aims to address the misdiagnosis of piriformis syndrome which has prolonged pain for many patients and increased the cost of medical care. It demonstrates a 76-year-old female with a confounding presentation of piriformis syndrome: buttock pain radiating down the thigh and lower leg, a positive straight-leg test, and a positive FAIR test. The diagnosis was ultimately confirmed with intramuscular piriformis injection. This study highlights the diagnostic difficulties between piriformis syndrome and lumbosacral radiculopathy and can be used as a guide to help improve care for lower radicular pain patients.

Disciplines

Medical Anatomy | Medical Pathology | Medical Physiology | Musculoskeletal Diseases | Musculoskeletal, Neural, and Ocular Physiology | Nervous System Diseases | Neurology | Osteopathic Medicine and Osteopathy | Other Rehabilitation and Therapy | Pathological Conditions, Signs and Symptoms | Primary Care | Sports Medicine

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Piriformis Syndrome With a Variant Presentation

Piriformis syndrome has long been a diagnostic quandary due to its tendency to present as other nerve-related conditions. Piriformis syndrome is commonly caused by entrapment of the sciatic nerve as it travels through the greater sciatic foramen due to hypertrophy of the piriformis muscle. However, its constellation of symptoms, including radiating pain down the thigh, can easily be mistaken for lumbosacral radiculopathy. This case report aims to address the misdiagnosis of piriformis syndrome which has prolonged pain for many patients and increased the cost of medical care. It demonstrates a 76-year-old female with a confounding presentation of piriformis syndrome: buttock pain radiating down the thigh and lower leg, a positive straight-leg test, and a positive FAIR test. The diagnosis was ultimately confirmed with intramuscular piriformis injection. This study highlights the diagnostic difficulties between piriformis syndrome and lumbosacral radiculopathy and can be used as a guide to help improve care for lower radicular pain patients.