Les syndromes canalaires des régions glutéales et de la face latérale de la hanche

[Relationships between piriformis muscle and sciatic nerve: radioanatomical study with 104 buttocks]

OBJECTIVE

The relationships between the piriformis muscle and the sciatic nerve are close and may be changing. In some cases, these relationships are the cause of a piriformis syndrome, an under-diagnosed etiology of non discal sciatica. The aim of the study was to explore, by the MRI, the sciatic nerve and the piriformis muscle. MATERIELS AND METHODS: One hundred and four buttocks were explored by MRI for 52 randomly selected patients.

RESULTS

In 59.6% of cases, no variation of the piriformis muscle and sciatic nerve were found. In 26% of cases, the sciatic nerve was divided into the pelvis. In 9.6% of cases, it was divided into the pelvis, the piriformis muscle was bifid and the common peroneal nerve ran between both heads. The piriformis muscle was bifid in 10.6% of cases, hypertrophic in 13.5% of cases and atrophic in 2.9% of cases.

Chiropractic management of chronic idiopathic meralgia paresthetica: a case study

OBJECTIVES

This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care.

CLINICAL FEATURES

A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction.

INTERVENTION AND OUTCOMES

Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh.

CONCLUSION

In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient.