Pelvic and Hip Morphometry in Piriformis Syndrome

NCT04600024 | Completed

• 1 other identifier: FSMEAH
• Study Type: observational
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Piriformis Muscle Syndrome; Anthropometry

Keywords

Anthropometry; Pelvic Bones; Muscle Syndrome, Piriformis; Prospective Studies; Case-Control Studies; femur neck / pathology

Outcome Measures

Primary Outcomes (5)

• Femoral Neck-Shaft Angle (NSA)

  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.

  The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.

• Posterior Superior Iliac Spine (PSIS)- Trochanter Major (TM)

  The distance between the posterior superior iliac spine and the greater trochanter

  The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.

• PSIS-Ischial Tuberosity (IT)

  The distance between the posterior superior iliac spine and the apex of the ischial tuberosity

  The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.

• IT-TM

  The distance between the apex of the ischial tuberosity and the greater trochanter

  The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.

• Sacrum-TM

  The distance between the sacrum and the greater trochanter

  The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.

Study Arms (2)

Piriformis syndrome group

Patients who were diagnosed as PS by diagnostic injection with ultrasound guidance

Diagnostic Test: Ultrasound guided diagnostic injection

Age and sex match control group

Patients who were excluded from the diagnosis of PS and had anteroposterior (AP) direct radiographic imaging

Interventions

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.

Piriformis syndrome group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The physical medicine and rehabilitation outpatient clinic of Fatih Sultan Mehmet Training and Research Hospital

You may qualify if:

• A dramatic relief of pain following piriformis muscle local anesthetic injection

You may not qualify if:

• 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
• Having Anteroposterior pelvic radiographs for other medical reasons
• 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

Sponsors & Collaborators

• Fatih Sultan Mehmet Training and Research Hospital: lead

Study Sites (1)

Fatih Sultan Mehmet Research and Traning Hospital

Istanbul, 34752, Turkey (Türkiye)

Location

Related Publications (26)

• Kirschner JS, Foye PM, Cole JL. Piriformis syndrome, diagnosis and treatment. Muscle Nerve. 2009 Jul;40(1):10-8. doi: 10.1002/mus.21318.

  PMID: 19466717 BACKGROUND

• Jankovic D, Peng P, van Zundert A. Brief review: piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth. 2013 Oct;60(10):1003-12. doi: 10.1007/s12630-013-0009-5. Epub 2013 Jul 27.

  PMID: 23893704 BACKGROUND

• Hopayian K, Song F, Riera R, Sambandan S. The clinical features of the piriformis syndrome: a systematic review. Eur Spine J. 2010 Dec;19(12):2095-109. doi: 10.1007/s00586-010-1504-9. Epub 2010 Jul 3.

  PMID: 20596735 BACKGROUND

• Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. Orthop Clin North Am. 2004 Jan;35(1):65-71. doi: 10.1016/S0030-5898(03)00105-6.

  PMID: 15062719 BACKGROUND

• Probst D, Stout A, Hunt D. Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment. PM R. 2019 Aug;11 Suppl 1:S54-S63. doi: 10.1002/pmrj.12189. Epub 2019 Jul 22.

  PMID: 31102324 BACKGROUND

• Benson ER, Schutzer SF. Posttraumatic piriformis syndrome: diagnosis and results of operative treatment. J Bone Joint Surg Am. 1999 Jul;81(7):941-9.

  PMID: 10428125 BACKGROUND

• Pace JB, Henning C. Episacroiliac lipoma. Am Fam Physician. 1972 Sep;6(3):70-3. No abstract available.

  PMID: 4262540 BACKGROUND

• Coskun Benlidayi I, Guzel R, Basaran S, Aksungur EH, Seydaoglu G. Is coxa valga a predictor for the severity of knee osteoarthritis? A cross-sectional study. Surg Radiol Anat. 2015 May;37(4):369-76. doi: 10.1007/s00276-014-1359-6. Epub 2014 Aug 12.

  PMID: 25113012 BACKGROUND

• Durrani Z, Winnie AP. Piriformis muscle syndrome: an underdiagnosed cause of sciatica. J Pain Symptom Manage. 1991 Aug;6(6):374-9. doi: 10.1016/0885-3924(91)90029-4.

  PMID: 1880438 RESULT

• Hopayian K, Danielyan A. Four symptoms define the piriformis syndrome: an updated systematic review of its clinical features. Eur J Orthop Surg Traumatol. 2018 Feb;28(2):155-164. doi: 10.1007/s00590-017-2031-8. Epub 2017 Aug 23.

  PMID: 28836092 RESULT

• Kean Chen C, Nizar AJ. Prevalence of piriformis syndrome in chronic low back pain patients. A clinical diagnosis with modified FAIR test. Pain Pract. 2013 Apr;13(4):276-81. doi: 10.1111/j.1533-2500.2012.00585.x. Epub 2012 Aug 2.

  PMID: 22863240 RESULT

• Hallin RP. Sciatic pain and the piriformis muscle. Postgrad Med. 1983 Aug;74(2):69-72. doi: 10.1080/00325481.1983.11698378. No abstract available.

  PMID: 6878094 RESULT

• Niu CC, Lai PL, Fu TS, Chen LH, Chen WJ. Ruling out piriformis syndrome before diagnosing lumbar radiculopathy. Chang Gung Med J. 2009 Mar-Apr;32(2):182-7.

  PMID: 19403008 RESULT

• Rodrigue T, Hardy RW. Diagnosis and treatment of piriformis syndrome. Neurosurg Clin N Am. 2001 Apr;12(2):311-9.

  PMID: 11525209 RESULT

• Misirlioglu TO, Akgun K, Palamar D, Erden MG, Erbilir T. Piriformis syndrome: comparison of the effectiveness of local anesthetic and corticosteroid injections: a double-blinded, randomized controlled study. Pain Physician. 2015 Mar-Apr;18(2):163-71.

  PMID: 25794202 RESULT

• Haladaj R, Pingot M, Polguj M, Wysiadecki G, Topol M. Anthropometric Study of the Piriformis Muscle and Sciatic Nerve: A Morphological Analysis in a Polish Population. Med Sci Monit. 2015 Dec 2;21:3760-8. doi: 10.12659/msm.894353.

  PMID: 26629744 RESULT

• Guvencer M, Akyer P, Iyem C, Tetik S, Naderi S. Anatomic considerations and the relationship between the piriformis muscle and the sciatic nerve. Surg Radiol Anat. 2008 Aug;30(6):467-74. doi: 10.1007/s00276-008-0350-5. Epub 2008 May 6.

  PMID: 18458807 RESULT

• Menge TJ, Truex NW. Femoroacetabular impingement: a common cause of hip pain. Phys Sportsmed. 2018 May;46(2):139-144. doi: 10.1080/00913847.2018.1436844. Epub 2018 Feb 13.

  PMID: 29406812 RESULT

• Krueger DR, Windler M, Gesslein M, Schuetz M, Perka C, Schroeder JH. Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions. Arch Orthop Trauma Surg. 2017 Jul;137(7):975-980. doi: 10.1007/s00402-017-2694-y. Epub 2017 Apr 21.

  PMID: 28432458 RESULT

• Bredella MA, Azevedo DC, Oliveira AL, Simeone FJ, Chang CY, Stubbs AJ, Torriani M. Pelvic morphology in ischiofemoral impingement. Skeletal Radiol. 2015 Feb;44(2):249-53. doi: 10.1007/s00256-014-2041-0. Epub 2014 Nov 6.

  PMID: 25371087 RESULT

• Gomez-Hoyos J, Schroder R, Reddy M, Palmer IJ, Martin HD. Femoral Neck Anteversion and Lesser Trochanteric Retroversion in Patients With Ischiofemoral Impingement: A Case-Control Magnetic Resonance Imaging Study. Arthroscopy. 2016 Jan;32(1):13-8. doi: 10.1016/j.arthro.2015.06.034. Epub 2015 Sep 7.

  PMID: 26358634 RESULT

• Boese CK, Frink M, Jostmeier J, Haneder S, Dargel J, Eysel P, Lechler P. The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis. Biomed Res Int. 2016;2016:8645027. doi: 10.1155/2016/8645027. Epub 2016 Dec 14.

  PMID: 28070521 RESULT

• Elbuken F, Baykara M, Ozturk C. Standardisation of the neck-shaft angle and measurement of age-, gender- and BMI-related changes in the femoral neck using DXA. Singapore Med J. 2012 Sep;53(9):587-90.

  PMID: 23023899 RESULT

• Gilligan I, Chandraphak S, Mahakkanukrauh P. Femoral neck-shaft angle in humans: variation relating to climate, clothing, lifestyle, sex, age and side. J Anat. 2013 Aug;223(2):133-51. doi: 10.1111/joa.12073. Epub 2013 Jun 19.

  PMID: 23781912 RESULT

• Fischer CS, Kuhn JP, Volzke H, Ittermann T, Gumbel D, Kasch R, Haralambiev L, Laqua R, Hinz P, Lange J. The neck-shaft angle: an update on reference values and associated factors. Acta Orthop. 2020 Feb;91(1):53-57. doi: 10.1080/17453674.2019.1690873. Epub 2019 Nov 18.

  PMID: 31735107 RESULT

• Fearon A, Stephens S, Cook J, Smith P, Neeman T, Cormick W, Scarvell J. The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study. Br J Sports Med. 2012 Sep;46(12):888-92. doi: 10.1136/bjsports-2011-090744. Epub 2012 Apr 30.

  PMID: 22547561 RESULT

MeSH Terms

Conditions

Piriformis Muscle Syndrome

Condition Hierarchy (Ancestors)

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

Study Officials

• Gamze Güleç, MD

  Fatih Sultan Mehmet Training and Research Hospital

  STUDY DIRECTOR

• Ilknur Aktas, MD

  Fatih Sultan Mehmet Training and Research Hospital

  STUDY DIRECTOR

• Feyza Unlu Ozkan, MD

  Fatih Sultan Mehmet Training and Research Hospital

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 18, 2020
• First Posted: October 23, 2020
• Study Start: April 20, 2018
• Primary Completion: March 18, 2020
• Study Completion: June 18, 2020
• Last Updated: October 23, 2020

Record last verified: 2020-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)