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NCT Number: NCT04600024

Pelvic and Hip Morphometry in Piriformis Syndrome

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.

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Key information

Conditions

Piriformis Muscle Syndrome Anthropometry Mononeuropathies Nerve Compression Syndromes Nervous System Diseases Neuralgia Neurologic Manifestations Neuromuscular Diseases Pain Pathological Conditions, Signs and Symptoms Pelvic Pain Peripheral Nervous System Diseases Sciatic Neuropathy Signs and Symptoms

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Fatih Sultan Mehmet Research and Traning Hospital

Istanbul, 34752, Turkey (Türkiye)

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

For Piriformis syndrome group (study group);

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

Treatment and study plan

Ultrasound guided diagnostic injection

Diagnostic Test

4 cc lidocaine %2 injection into the piriformis muscle was performed for the diagnosis of piriformis syndrome. It was performed by the ultrasound-guidance to increase the accuracy of the injection.

Primary outcomes

  1. Femoral Neck-Shaft Angle (NSA)

    Time frame: 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.

  2. Posterior Superior Iliac Spine (PSIS)- Trochanter Major (TM)

    Time frame: 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

  3. PSIS-Ischial Tuberosity (IT)

    Time frame: 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

  4. IT-TM

    Time frame: 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

  5. Sacrum-TM

    Time frame: 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

Sponsors and collaborators

Lead sponsor

Fatih Sultan Mehmet Training and Research Hospital

Other

Registry information

Official study title

The Importance of Pelvic Morphometric Measurements in Piriformis Syndrome: A Case-control Study

Important dates

Study start
2018
Primary completion
2020
Study completion
2020
First posted
Oct 23, 2020
Registry last updated
Oct 23, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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