Piriformis Syndrome Caused by Synovial Osteochondromatosis of the Hip. A Case Report.:A Case Report

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This report concerns a rare case of piriformis syndrome caused by synovial osteochondromatosis of the hip. The patient involved was a 67-year-old female who visited our hospital complaining of left hip joint and buttock pain.On examination she had a positive sign of Pace and sign of Freiburg. The findings on straight-leg-raising and all other radicular provocation testing were negative. Preoperative MRI suggested that the obturatorius externus muscle and its surrounding region were inflammatory.Injection of a local anesthesic at the site of a trigger-point over the muscle temporarily alleviated the symptoms.Based on the above findings we diagnosed the patient as having piriformis syndrome and performed surgery. The sciatic nerve was found in its normal anatomical location and the nerve itself appeared normal. However, a part of the nerve was flattened. An incision was mede in the piriformis muscle. The hip joint capsule was swollen and we incised the capsule. Many intraarticular free bodies were removed from the hip joint.We concluded that bulging resulting from osteochondromatosis of the hip caused the piriformis syndrome.After surgery, clinical symptoms disappeared.
西日本整形・災害外科学会の論文