A Case of Non-Disc, Non Piriformis Syndrome Sciatica
Keywords:
Electromyography, EDX Medicine, Non Disc, Piriformis Syndrome, Pelvis MRI, Quadratus Femoris Muscle, SciaticaAbstract
A 40 year old runner developed buttock pain, with radiating symptoms down his right leg. The pain was exacerbated by exercise. He had sustained a minor injury to his back and pelvis, when he slipped on a kerb while running 6 months earlier. The patient stated that he straightened his leg and abducted his hip in an effort to avoid falling. His examination revealed a positive straight leg raise at 100 degrees; His right S1 ankle reflex was absent.
A lumbar spine MRI scan was normal. A needle EMG confirmed acute on chronic denervation in the L5 and S1 distribution with a normal paraspinal screen.
His Tibial H reflex was normal in the supine position, but showed focal slowing and amplitude loss when the hip was placed in a forced flexed and adducted position.
An MRI of pelvis was sought to assess for focal entrapment of the sciatic nerve by the piriformis muscle. The piriformis muscle was normal but the quadratus femoris[QF] muscle showed evidence of a local muscle tear and tendonitis with associated effusion.
The symptoms resolved following steroid injection at the level of the QF tendon injury and effusion, under ultrasound and EMG guidance.
The case describes an example of an acute on chronic sciatica caused by a local injury to the quadratus femoris muscle.
Published
How to Cite
Issue
Section
Copyright (c) 2021 Journal of Sports Medicine and Orthopedic Advances
This work is licensed under a Creative Commons Attribution 4.0 International License.