Piriformis syndrome: treatment of a rare cause of posterior hip pain with fluoroscopic-guided injection

• Published in: Hip international 2015-03, Vol.25 (2), p.172-175
• Main Authors: Albayrak, Akif, Ozcafer, Rasit, Balioglu, Mehmet B, Kargin, Deniz, Atici, Yunus, Ermis, Mehmet N
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthralgia - drug therapy; Arthralgia - etiology; Cohort Studies; Female; Fluoroscopy - methods; Hip Joint; Humans; Injections, Intramuscular; Male; Methylprednisolone - administration & dosage; Methylprednisolone - analogs & derivatives; Middle Aged; Pain Management - methods; Patient Positioning - methods; Patient Satisfaction; Piriformis Muscle Syndrome - complications; Piriformis Muscle Syndrome - diagnostic imaging; Piriformis Muscle Syndrome - drug therapy; Prospective Studies; Treatment Outcome; Visual Analog Scale; Young Adult
• ISSN: 1120-7000; 1724-6067
• DOI: 10.5301/hipint.5000219

Piriformis syndrome involves the irritation of the piriformis muscle due to various reasons that are primarily related to anatomical variation or sciatic nerve compression due to contraction caused by overuse. In this study, we aimed to define an injection method that is easy to apply, safe, simple and repeatable. We administered percutaneous lidocaine and depomedrol injections into the hips of 28 patients (14 men and 14 women) under fluoroscopic control. Bipolar injections of the piriformis muscle were performed at the medial pole, the intersection of the sciatic notch and the sacroiliac joint, and at the lateral pole of the femoral insertion region. Each injection was 5 cc, and the contrast agent was observed after the dyeing process. Clinical examinations were performed before and 6 weeks after the injections. The average of Harris Hip Score increased from a pre-injection score of 44.5 to a post-injection score of 68.5, and the Visual Analog Scale scores decreased from 8.3 to 4.2 (p