Keywords:
Neuroradiology peripheral nerve, Ultrasound physics, Musculoskeletal system, Elastography, Ultrasound, Treatment effects, Computer Applications-General, Connective tissue disorders
Authors:
S. B. Stajic1, A. Vojvodic1, J. Mihailovic1, L. P. Carro2; 1Belgrade/RS, 2Santander/ES
DOI:
10.1594/ecr2018/C-0399
Aims and objectives
The clinical entity of piriformis syndrome (PS) is a matter of controversy [1,2].
The ability to recognize PS requires an understanding of the structure and function of the piriformis muscle and its relationship to the sciatic nerve.
Namely,
multiple pathologies have been incorporated in this all-included "piriformis syndrome",
a term that has nothing to do with the presence of fibrous bands,
obturator internus/gemmelus syndrome,
quadratus femoris/ischiofemoral pathology,
hamstring condition,
gluteal disorders.
That is why it is more appropiate to define it as deep gluteal syndrome (DGS).
Different theories exist to support the premise that piriformis muscle itself either compress or irritates the sciatic nerve.
Despite considerable attention given to DGS lately,
it remains a controversial clinical syndrome,
as only limited opportunities exist to confirm its diagnosis by means of technical studies.
Potentially useful diagnostic criteria may be Ultra Sound elastography (USE) images [3,4].
The technology can be considered to be an imaging base counterpart to palpation.
The success of palpation as a diagnostic method is based on the fact that the mechanical properties of the tissues are often dramatically affected by the presence of disease processes such as inflammation and fibrosis which is of the most importance in DGS and nerve entrapment.
Elastography obtains information about the stiffness of tissue by assessing the propagation of mechanical waves through the tissue,
which can be seen through specially color coded maps (Fig.1,2,3,4,5,6).
The objective of the proposed study is research and development of new techniques for diagnosis of deep gluteal syndrome and sciatic nerve entrapment.