HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space.

Abstract
Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. 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/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation.
AuthorsMoisés Fernández Hernando, Luis Cerezal, Luis Pérez-Carro, Faustino Abascal, Ana Canga
JournalSkeletal radiology (Skeletal Radiol) Vol. 44 Issue 7 Pg. 919-34 (Jul 2015) ISSN: 1432-2161 [Electronic] Germany
PMID25739706 (Publication Type: Journal Article, Review)
Chemical References
  • Anti-Inflammatory Agents
  • Neuromuscular Agents
Topics
  • Anti-Inflammatory Agents (therapeutic use)
  • Arthralgia (diagnosis, prevention & control)
  • Buttocks (pathology, surgery)
  • Combined Modality Therapy (methods)
  • Diagnosis, Differential
  • Endoscopy (methods)
  • Hip Joint (pathology, surgery)
  • Humans
  • Magnetic Resonance Imaging (methods)
  • Neuromuscular Agents (therapeutic use)
  • Physical Therapy Modalities
  • Piriformis Muscle Syndrome (diagnosis, therapy)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: