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Myositis Ossificans of the Piriformis Muscle: An Unusual Cause of Piriformis Syndrome: A Case Report*
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Investigation performed at Hartford Hospital, Hartford
J Bone Joint Surg Am, 1997 Jun 01;79(6):906-10
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Piriformis syndrome is the result of entrapment of the sciatic nerve by the piriformis muscle as it passes through the sciatic notch. Because of its relative rarity, a high index of suspicion is necessary to make the diagnosis4,15,22,24. Etiologies have included hypertrophy of the piriformis muscle3,11,16; trauma17,26; pseudoaneurysm of the inferior gluteal artery17; excessive exercise12; and inflammation and spasm of the piriformis muscle19, often in association with trauma11,20, infection2, and anatomical variations of the muscle1,10,18. The syndrome also has been reported in association with dystonia musculorum deformans8. To our knowledge, traumatic myositis ossificans of the piriformis muscle has not been described previously as a cause of piriformis syndrome. We report the case of a patient in whom the sciatic nerve was compressed between the piriformis muscle and the roof of the sciatic notch; bone-scanning, computerized axial tomography, magnetic resonance imaging, and histopathological testing indicated that the compression was secondary to myositis ossificans of the piriformis muscle.
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