Thrombosed persistent sciatic artery presenting with pain in the buttock

A 62-year-old woman presented to the clinic with a one-month history of pain in the left buttock. The pain was in the gluteal region and occurred especially during prolonged uphill walking and sitting. There was no tingling or numbness in the lower extremity. On neurologic examination, she had symme...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2017-08, Vol.189 (32), p.E1042-E1042
Main Authors: Chen, Nai-Ching, Chen, Chien-Liang
Format: Article
Language:English
Subjects:
Aneurysms
Buttocks - blood supply
Care and treatment
Case studies
Chronic Pain - diagnosis
Chronic Pain - etiology
Diagnosis
Diagnosis, Differential
Female
Humans
Iliac Artery
Ischemia
Magnetic Resonance Imaging
Medical imaging
Middle Aged
NMR
Nuclear magnetic resonance
Older people
Pain
Practice
Sciatic Nerve - blood supply
Thrombosis
Thrombosis - complications
Thrombosis - diagnosis
Tomography, X-Ray Computed
Women
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Summary:A 62-year-old woman presented to the clinic with a one-month history of pain in the left buttock. The pain was in the gluteal region and occurred especially during prolonged uphill walking and sitting. There was no tingling or numbness in the lower extremity. On neurologic examination, she had symmetric sensation. Her result for the straight leg--raising test was negative. Given her symptoms and results from physical examination, sciatica seemed unlikely; other possibilities included trochanteric bursitis and muscle injury. Most cases of persistent sciatic artery are clinically silent in the early stages and detected only after patients show symptoms of vascular complication (e.g., aneurysm, embolism or rupture). Symptoms can include a pulsating mass, pain in the buttock or acute lower leg ischemia, which may require amputation (8%). Imaging with multiplanar CT or MRI may show the relation among the structures around the persistent sciatic artery.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.161321