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D e   f   i   n   i   t i   o n
E t   i   o   l   o   g y
C l   i   n   i   c   a l    f e a t u r e s
C l   i   n   i   c   a l    d i a g n o s i s
M a   n   a   g   e   me    n t
T h   e p i r i f o r mi s
 s y   n d r o me i s a
 c o   n d i t i o n i n wh i c h
 t h   e p i r i f o r mi s
 mu    s c l e i r r i t a t e s o r
 c o   mp r e s s t h e s c i a t i c
 n e   r v e , c a u s i n g p a i n
 i n    t h e g l u t i a l
 r e   g i o n , p o s t e r i o r
 t h   i g h a n d a l o n g t h e
P r o l o n g e d
 s p a s m               T wi s t i n g
                          i n j u r y o n
I n f l a mma t i        f i x e d l e g .
 o n

S   h o r t e n i n g
R   a d i a t i n g p a i n
P a i n wh i l e wa l k i n g ,
 c l i mb i n g s t a i r s a n d
 r o t a t i o n o f t r u n k .
T   e n d e r n e s s
 We a   k   n e s s o    f    h i p
 a b d   u   c t i o n    a   n d
 e x t   e   r n a l r    o   t a t i o n ,
 k n e   e    f l e x i   o   n .
S   e n s o r y d e f i c i t s .
N o d i a g n o s t i c t e s t s ,
 MR I , C T , N C V t o r u l e
 o u t s c i a t i c a .

P   i r i f o r mi s t e s t .

D i r e c t   p a l p a t i o n
 t e s t .
M e   d i c a l   ma n a g e me n t .


Ph y s i o t h e r a p y
 ma n a g e me n t .
N   SAI D.

m u   s c l e r e l a x a n t s .

L o   c   a   l   I n j e c t i o n s
 wi    t   h    a
 c o   r   t   i c o s t e r o i d o r
 a n   e   s   t h e t i c .

S   u r g e r y
G e n t l e , s t a t i c
 s t r e t c h i n g .

U   l t r a s o u n d    Th e r a p y .

M a   s s a g e .

H i   p    Ab d u c t o r a n d
 e x   t   e r n a l r o t a t o r
 s t   r   e n g t h e n i n g
 e x   e   r c i s e s .
Pi r i f o r mi s   P i r i f o r mi s
 mu s c l e .         t e s t .

S c i a t i c       D i r e c t
 n e r v e .          p a l p a t i o n .

P r i f o r mi s    Me d i c a l
 s y n d r o me .     ma n a g e me n t
                      .
C   a u s e s .
                     PT
C   l i n i c a l    ma n a g e me n t
   So f t t i s s u e p a i n a n d
    d i s a b i l i t y - Re n e
    Ca l i l a t .
   D i a g n o s i s a n d t r e a t me n t
    o f l o w e r e x t r i mi t i e s -
    D o s Wi n k e l .
   Or t h o p e a d i c
    p h y s i o t h e r a p y -R o b e r t
    Do n a t e l l i .
   Pa l p a t i o n s k i l l s –
    A s s e s s me n t a n d
    d i a g n o s i s t h r o u g h t o u c h -
Piriformis syndrome

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Piriformis syndrome

  • 1.
  • 2. D e f i n i t i o n E t i o l o g y C l i n i c a l f e a t u r e s C l i n i c a l d i a g n o s i s M a n a g e me n t
  • 3. T h e p i r i f o r mi s s y n d r o me i s a c o n d i t i o n i n wh i c h t h e p i r i f o r mi s mu s c l e i r r i t a t e s o r c o mp r e s s t h e s c i a t i c n e r v e , c a u s i n g p a i n i n t h e g l u t i a l r e g i o n , p o s t e r i o r t h i g h a n d a l o n g t h e
  • 4.
  • 5. P r o l o n g e d s p a s m T wi s t i n g i n j u r y o n I n f l a mma t i f i x e d l e g . o n S h o r t e n i n g
  • 6. R a d i a t i n g p a i n P a i n wh i l e wa l k i n g , c l i mb i n g s t a i r s a n d r o t a t i o n o f t r u n k . T e n d e r n e s s  We a k n e s s o f h i p a b d u c t i o n a n d e x t e r n a l r o t a t i o n , k n e e f l e x i o n . S e n s o r y d e f i c i t s .
  • 7.
  • 8. N o d i a g n o s t i c t e s t s , MR I , C T , N C V t o r u l e o u t s c i a t i c a . P i r i f o r mi s t e s t . D i r e c t p a l p a t i o n t e s t .
  • 9. M e d i c a l ma n a g e me n t . Ph y s i o t h e r a p y ma n a g e me n t .
  • 10. N SAI D. m u s c l e r e l a x a n t s . L o c a l I n j e c t i o n s wi t h a c o r t i c o s t e r o i d o r a n e s t h e t i c . S u r g e r y
  • 11. G e n t l e , s t a t i c s t r e t c h i n g . U l t r a s o u n d Th e r a p y . M a s s a g e . H i p Ab d u c t o r a n d e x t e r n a l r o t a t o r s t r e n g t h e n i n g e x e r c i s e s .
  • 12. Pi r i f o r mi s P i r i f o r mi s mu s c l e . t e s t . S c i a t i c D i r e c t n e r v e . p a l p a t i o n . P r i f o r mi s Me d i c a l s y n d r o me . ma n a g e me n t . C a u s e s . PT C l i n i c a l ma n a g e me n t
  • 13. So f t t i s s u e p a i n a n d d i s a b i l i t y - Re n e Ca l i l a t .  D i a g n o s i s a n d t r e a t me n t o f l o w e r e x t r i mi t i e s - D o s Wi n k e l .  Or t h o p e a d i c p h y s i o t h e r a p y -R o b e r t Do n a t e l l i .  Pa l p a t i o n s k i l l s – A s s e s s me n t a n d d i a g n o s i s t h r o u g h t o u c h -