Learning objectives
1. To understand the anatomy and course of sciatic nerve. 2. To understand the concept of extraspinal sciatica. 3. To elucidate the importance of Pyriformis syndrome and its clinical significance. 4. To illustrate the causes of pelvic and extra pelvic sciatic nerve compression.
Background
Uncommonly, sciatic nerve can be compressed during its course to and beyond greater sciatic notch. This exhibit focuses on MR imaging of extraspinal sciatica highlighting the gamut of causes. Sciatic nerve Anatomy FACT FILE The sciatic nerve is formed from the L4 through S3 roots. These roots of the sacral plexus form on the anterior surface of the lateral sacrum and are assembled into the sciatic nerve on the anterior surface of the priformis muscle. The sciatic nerve is the largest nerve in the body...
Imaging findings OR Procedure details
This exhibit highlights the importance of comprehensive backache protocol with imaging of sciatic nerve in routine clinical practice to evaluate its extraspinal compression in pelvis and demonstrate the extra pelvic causes (beyond sciatic notch). All patients were imaged on 1.5T /3T MRI systems at two imaging centers using a multichannel spine coil, pelvic phased array coil. 2D steady state FIESTA axials, c oronals and sagittals, STIR coronal and pre and post contrast T1 weighted fat suppressed sequences. For MR neurography an additional DWIBS (diffusion weighted...
Conclusions
MR neurography sequence should be included in a comprehensive backache protocol in patient with sciatica to rule out extra pelvic sciatic nerve compression and lesion characterization.
Personal Information
Rammohan Vadapalli(VSV) MD Senior Consultant radiologist 1.Vijaya diganostics ,Hyderabad 2.Visiting consultant and Advisor :manipal Hospitals,Bangalore,India 3.Asiri surgical hospitals,Colombo,Sri Lanka
References
1. Banerjee T, Hall CD. Sciatic entrapment neuropathy. Neurosurgery 1976;45:216–7. 2. Benyahya E, Etaouil N, Janani S, et al. Sciatica as the first manifestation ofleiomyosarcoma of the buttock. Rev Rheum 1997;64:135–137. 3. Harrison MJ, Leis HT, Johnson BA, MacDonald WD, Goldman CD. Hemangiopericytomaof the sciatic notch presenting as sciatica in a young healthyman: Case report. Neurosurgery 1995;37:1208–11. 4. Johanson NA, Pellicii PM, Tsairis P, Salvati EA. Nerve injury in total hiparthroplasty. Clin Orthop 1983;179:214–22. 5. Jones BV, Ward MW. Myositis ossificans in the biceps femoris...
