Clinical History
43 year old female with left buttock pain and intermittent sciatica. Ultrasound guided botox injection of the piriformis muscle was requested.
Ultrasound of the Month – Case 152
1
Ultrasound of the Month – Case 152 2
Diagnosis: Piriformis Syndrome
Piriformis syndrome is abnormality of the piriformis muscle that can irritate the adjacent sciatic nerve, presenting as buttock pain with or without sciatica.
The existence of this entity is controversial, and MRI and ultrasound usually do not reveal any abnormality.
Treatment is also controversial, but if physical therapy fails, intramuscular botox injection has been described as a treatment option.
In experienced hands, ultrasound is an appropriate modality for guiding injections into the piriformis muscle.
CT-guidance is an alternative option but requires ionizing radiation.
Ultrasound of the Month – Case 152
3