Pain in the hip, buttocks, or thigh. Often pain when sitting or with certain hip movements. Often unilateral radiating pain.[1]
Causes
Most common are (1) fibrotic adhesions tethering the sciatic nerve and (2) piriformis syndrome.[2]
Diagnostic method
First ruling out lumbar pathology. Then stretch/activation tests, magnetic resonance imaging / magnetic resonance neurography, and diagnostic injections.[3]
Conservative treatments include physical therapy, analgesics, and injections.[2][4]
Surgical treatment is a sciatic nerve decompression and/or muscle resection.[5]
Deep gluteal syndrome describes the non-discogenic extrapelvic entrapment of the sciatic nerve in the deep gluteal space.[1] It is an extension of non-discogenic sciatic nerve entrapment beyond the traditional model of piriformis syndrome.[4] Symptoms are pain or dysthesias the buttocks, hip, and posterior thigh with or without radiating leg pain. Patients often report pain when sitting.[1] The two most common causes are piriformis syndrome and fibrovascular bands, but many other causes exist.[2] Diagnosis is usually done through physical examination, magnetic resonance imaging, magnetic resonance neurography, and diagnostic nerve blocks.[6] Surgical treatment is an endoscopic sciatic nerve decompression.[7]
^ abcdCite error: The named reference :0 was invoked but never defined (see the help page).
^ abcMetikala S, Sharma V (March 2022). "Endoscopic Sciatic Neurolysis for Deep Gluteal Syndrome: A Systematic Review". Cureus. 14 (3): e23153. doi:10.7759/cureus.23153. PMC 9010003. PMID 35444897.
^Cite error: The named reference :9 was invoked but never defined (see the help page).
^ abPark JW, Lee YK, Lee YJ, Shin S, Kang Y, Koo KH (May 2020). "Deep gluteal syndrome as a cause of posterior hip pain and sciatica-like pain". Bone Joint J. 102-B (5): 556–567. doi:10.1302/0301-620X.102B5.BJJ-2019-1212.R1. PMID 32349600. S2CID 217593533.
^Cite error: The named reference :8 was invoked but never defined (see the help page).
^Cite error: The named reference :1 was invoked but never defined (see the help page).
^Kay J, de Sa D, Morrison L, Fejtek E, Simunovic N, Martin HD, Ayeni OR (December 2017). "Surgical Management of Deep Gluteal Syndrome Causing Sciatic Nerve Entrapment: A Systematic Review". Arthroscopy. 33 (12): 2263–2278.e1. doi:10.1016/j.arthro.2017.06.041. PMID 28866346.
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