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
Methods and materials
27 subjects (female=19 and male=8) with a mean age of 44 years were included in the review.
All patients complained to low back pain of several years duration.
During that period,
they had a persistent pain develop in their buttock area around sciatic nerve and piroformis region with spasm.
Patients did not recall any history of trauma.
On clinical examination,
the patients had full range of motion of lower extremity.
They were nontender to palpation above lower back.
Palpation of the sciatic notch was painful and accompanied by numbness radiating down the leg.
The FAIR and Lazarevic signs were positive.
Also,
cortical test was positive.
The radiographs and the MRI image of the lumbar spine and pelvis showed no pertinent findings.
The patienst started on a course of non-operative treatment,
including physical therapy,
non-steroidal antiinflammatories.
These non-operative measures did not result in a considerable relief of symptoms.
The sciatic nerve was scanned using ultrasound elastography imaging in the posterior thigh in healthy and individuals with spinally referred leg pain.
The nerve typically visualized at a depth of 6 to 8 cm depending on the region of field of view (Fig.3,4,5,6,7,8,9,10).
Ultrasound machine with curved transducer (2-8 MHz-low frequencies) was used.
Nerve excursion was measured in transverse and longitudinal planes during a modified FAIR test.
The ultrasound elastography data was analyzed off-line using cross correlation software.
After USE imaging 13 of 19 patients andervent surgical examination with open surgery which considered tenothomy of m.piriformis,
m.obturator internus and liberalization sciatic nerve of fibrous bands.