Piriformis Syndrome Case Study

What are my first thoughts about this case study?
• When I first read about Carla’s presentation into the clinic, it sounded like it was piriformis syndrome. Although rarely recognized, piriformis syndrome appears to be a common cause of buttock and leg pain as a result of injury to the piriformis muscle. Symptoms are aggravated by prolonged hip flexion, adduction, and internal rotation, in the absence of low back or hip findings (Barton, 1991). Tonley et al. (2010) stated piriformis syndrome often evolves as intermittent and inconsistent and can present symptoms off and on throughout prolonged periods of time. Patients often report pain is insidious and deny any trauma that contributed to current symptoms. Patients also often state prolonged history of deep right buttock pain that radiates to the posterior thigh when piriformis syndrome is present (Tonley et al., 2010).
• Passive motion assessment of the hip joint in patients with piriformis syndrome often reveals normal ranges of motion for hip flexion, internal rotation, and external rotation without reproduction of symptoms (Tonley et al., 2010). Manual muscle testing above revealed slight weakness in the hamstrings which may be related to lower-crossed syndrome (LCS). In LCS, tightness of the thoracolumbar extensors on the
According to Mavrogenis, Patapis, Kostopanagiotou, and Papagelopoulos (2009), conventional radiograph has a limited sensitivity and is only significant when it is abnormal showing the degree of osteolysis and sclerosis, and gross calcification or ossification within bone or adjacent soft tissue, or a pelvic mass. The presence of these signs requires further imaging evaluation by bone scintigraphy, computed tomography (CT) scan, or magnetic resonance imaging (MRI) (Mavrogenis, Patapis, Kostopanagiotou, & Papagelopoulos,