Ultrasound elastography findings in piriformis muscle syndrome

Background: Piriformis muscle syndrome (PMS) is relatively less known and underestimated because it is confused with other clinical pathological conditions. Delays in its diagnosis may lead to chronic somatic dysfunction and muscle weakness. Objective: Here, we aimed to evaluate the diagnostic perfo...

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Main Authors: Adnan Demirel, Murat Baykara, Tuba Tülay Koca, Ejder Berk
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2018-10-01
Series:Indian Journal of Radiology and Imaging
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/ijri.IJRI_133_18
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author Adnan Demirel
Murat Baykara
Tuba Tülay Koca
Ejder Berk
author_facet Adnan Demirel
Murat Baykara
Tuba Tülay Koca
Ejder Berk
author_sort Adnan Demirel
collection DOAJ
description Background: Piriformis muscle syndrome (PMS) is relatively less known and underestimated because it is confused with other clinical pathological conditions. Delays in its diagnosis may lead to chronic somatic dysfunction and muscle weakness. Objective: Here, we aimed to evaluate the diagnostic performance of the ultrasound elastography (UE) as an easy, less-invasive, and cost-effective method for early diagnosis of PMS. Materials and Methods: Twenty-eight cases clinically diagnosed as PMS at the outpatient clinic were evaluated by UE. The elastographic strain ratio was calculated by dividing the strain value of the subcutaneous fat tissue by the mean stress value of the muscle beneath. The diagnostic performances of the strain rate measures were compared using the receiver operating characteristic curve analysis. Results: Twenty-one (N = 21) cases were female, and seven (N = 7) of the cases were male. The mean age was 45 years (ranged 24–62 years). The strain rates of piriformis muscle (PM) and gluteus maximus (GM) muscles were significantly higher on the PMS-diagnosed side (P < 0.001). The cutoff value of UE strain ratio for the PM and GM were 0.878 [95% confidence interval (CI) 0.774–0.981] and 0.768 (95% CI 0.622–0.913), respectively, and the sensitivity and specificity values were, respectively, 80.95% and 85.71% for the PM, and they were, respectively, 85.71% and 66.67% for the GM. Conclusion: We showed that the muscle elasticity and tissue hardening increased on the problematic side both on PM and GM. UE may provide early diagnosis of PMS, thereby increasing the possibility of treatment with less invasive methods.
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spelling doaj.art-90867f984972408db1bc652f31f352622022-12-21T22:05:47ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Radiology and Imaging0971-30261998-38082018-10-01280441241810.4103/ijri.IJRI_133_18Ultrasound elastography findings in piriformis muscle syndromeAdnan Demirel0Murat Baykara1Tuba Tülay Koca2Ejder Berk3Departments of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, TurkeyDepartments of Physical Medicine and Radiology, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, TurkeyDepartments of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, TurkeyDepartments of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, TurkeyBackground: Piriformis muscle syndrome (PMS) is relatively less known and underestimated because it is confused with other clinical pathological conditions. Delays in its diagnosis may lead to chronic somatic dysfunction and muscle weakness. Objective: Here, we aimed to evaluate the diagnostic performance of the ultrasound elastography (UE) as an easy, less-invasive, and cost-effective method for early diagnosis of PMS. Materials and Methods: Twenty-eight cases clinically diagnosed as PMS at the outpatient clinic were evaluated by UE. The elastographic strain ratio was calculated by dividing the strain value of the subcutaneous fat tissue by the mean stress value of the muscle beneath. The diagnostic performances of the strain rate measures were compared using the receiver operating characteristic curve analysis. Results: Twenty-one (N = 21) cases were female, and seven (N = 7) of the cases were male. The mean age was 45 years (ranged 24–62 years). The strain rates of piriformis muscle (PM) and gluteus maximus (GM) muscles were significantly higher on the PMS-diagnosed side (P < 0.001). The cutoff value of UE strain ratio for the PM and GM were 0.878 [95% confidence interval (CI) 0.774–0.981] and 0.768 (95% CI 0.622–0.913), respectively, and the sensitivity and specificity values were, respectively, 80.95% and 85.71% for the PM, and they were, respectively, 85.71% and 66.67% for the GM. Conclusion: We showed that the muscle elasticity and tissue hardening increased on the problematic side both on PM and GM. UE may provide early diagnosis of PMS, thereby increasing the possibility of treatment with less invasive methods.http://www.thieme-connect.de/DOI/DOI?10.4103/ijri.IJRI_133_18elastographypiriformis muscle syndromeultrasound
spellingShingle Adnan Demirel
Murat Baykara
Tuba Tülay Koca
Ejder Berk
Ultrasound elastography findings in piriformis muscle syndrome
Indian Journal of Radiology and Imaging
elastography
piriformis muscle syndrome
ultrasound
title Ultrasound elastography findings in piriformis muscle syndrome
title_full Ultrasound elastography findings in piriformis muscle syndrome
title_fullStr Ultrasound elastography findings in piriformis muscle syndrome
title_full_unstemmed Ultrasound elastography findings in piriformis muscle syndrome
title_short Ultrasound elastography findings in piriformis muscle syndrome
title_sort ultrasound elastography findings in piriformis muscle syndrome
topic elastography
piriformis muscle syndrome
ultrasound
url http://www.thieme-connect.de/DOI/DOI?10.4103/ijri.IJRI_133_18
work_keys_str_mv AT adnandemirel ultrasoundelastographyfindingsinpiriformismusclesyndrome
AT muratbaykara ultrasoundelastographyfindingsinpiriformismusclesyndrome
AT tubatulaykoca ultrasoundelastographyfindingsinpiriformismusclesyndrome
AT ejderberk ultrasoundelastographyfindingsinpiriformismusclesyndrome