Pelvic and Hip Morphometry in Piriformis Syndrome

Completed

• Conditions: Piriformis Muscle Syndrome; Anthropometry
• Interventions: Diagnostic Test: Ultrasound guided diagnostic injection

• Registration Number: NCT04600024
• Lead Sponsor: Fatih Sultan Mehmet Training and Research Hospital

Brief Summary

In this case-control study, 23 patients diagnosed as PS by diagnostic injection with ultrasound guidance were selected as the study group. 22 patients who were excluded from the diagnosis of PS and had anteroposterior (AP) direct radiographic imaging were evaluated as the control group. On the AP Pelvic graph, the femoral neck-shaft angle, the distances between predetermined bony landmarks were measured blindly without knowing the diagnosis, and the findings were compared statistically.

This study aims to evaluate whether the anatomical structure of the pelvis predisposes to the etiopathogenesis of the piriformis syndrome.

Detailed Description

Piriformis syndrome (PS) is a neuromuscular disorder consisting of pain and symptoms caused by compression of the sciatic nerve and other structures that pass under the piriformis muscle (PM). Due to difficulties in diagnosis, PS is confused with other pathologies such as lumbar disc pathology, lumbosacral radiculopathy, and sacroiliac dysfunction. As a result, patients are exposed to unnecessary and ineffective treatments, even surgery. The main problems in the PS diagnosis are the absence of objective physical examination findings, radiological findings, and a clear etiology. When the pathophysiology and etiology of PS are considered, there is no identifiable cause in most patients. Previous studies suggest that trauma, anatomical variations, and the trigger point in the muscle may cause PS. No study in the literature radiologically examined the pelvis or hip bone morphological features in PS to the best of our knowledge. This study aims to determine whether pelvic or hip bone morphology features pose a risk for PS in this study.

Study Timeline

• Study Start: 2018-04-20
• Primary Completion: 2020-03-18
• Study Completion: 2020-06-18
• Status Verified: 2020-09
• Study First Submitted: 2020-10-18
• Study First Submitted QC: 2020-10-22
• Last Update Submitted: 2020-10-22
• Study First Posted: 2020-10-23
• Last Update Posted: 2020-10-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 45

Inclusion Criteria

• A dramatic relief of pain following piriformis muscle local anesthetic injection

Exclusion Criteria

• Having a neurological deficiency
• Having lumbar, sacroiliac, hip, and thoracolumbar pathology (inflammatory or degenerative)
• Operation history at the lumbar and hip region
• Being in the gestational or lactational period
• Body mass index of greater than 35
• History of inflammatory or infectious disease
• Active psychiatric illness, severe systemic, vascular or malign disease

For the control group

Inclusion criteria:

-Having Anteroposterior pelvic radiographs for other medical reasons

Exclusion criteria:

• Having a present piriformis syndrome or a history of piriformis syndrome
• Having a neurological deficiency
• Having lumbar, sacroiliac, hip, and thoracolumbar pathology (inflammatory or degenerative)
• Operation history at the lumbar and hip region
• Being in the gestational or lactational period
• Body mass index of greater than 35
• History of inflammatory or infectious disease
• Active psychiatric illness, severe systemic, vascular or malign disease

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Piriformis syndrome group	Ultrasound guided diagnostic injection	Patients who were diagnosed as PS by diagnostic injection with ultrasound guidance

Primary Outcome Measures

Name	Time	Method
PSIS-Ischial Tuberosity (IT)	The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.	The distance between the posterior superior iliac spine and the apex of the ischial tuberosity
IT-TM	The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.	The distance between the apex of the ischial tuberosity and the greater trochanter
Femoral Neck-Shaft Angle (NSA)	The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.	The NSA, also called caput collum-diaphyseal angle or inclination angle, defined as the angle between the longitudinal femoral shaft axis and femoral head-neck axis.
Sacrum-TM	The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.	The distance between the sacrum and the greater trochanter
Posterior Superior Iliac Spine (PSIS)- Trochanter Major (TM)	The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.	The distance between the posterior superior iliac spine and the greater trochanter

Trial Locations

Locations (1)

Fatih Sultan Mehmet Research and Traning Hospital; 🇹🇷 Istanbul, Turkey