Piriformis syndrome: a case series of 31 Bangladeshi people with literature review.

AIMS: To describe a series of piriformis syndrome patient among Bangladesh people with literature review. METHODS: Consecutive 31 piriformis syndrome patients were enrolled. Besides history and clinical examination, piriformis muscle thickness was also measured with diagnostic ultrasound (3.5 MHZ). MRI of lumbar spine, X-rays of lumbo-sacral spine, and pelvis were performed in all patients. Statistical Package for the Social Sciences (SPSS), Windows 8.0, was used for statistical calculation, and univariate analysis of primary data was done. Data present with frequency table. For literature review concerning piriformis syndrome we used Embase, Pubmed, Medline, and Cochrane database. RESULTS: A total of 31 patients (21 female) with PS were enrolled, 21 housewives. Mean age 42.2 ± 14.5 years. All presented with buttock pain, aggravating with long sitting (31), lying on the affected side (31), during rising from a chair(24), and forward bending (28). Six reported pain improvement while walking. Gluteal tenderness, positive FAIR test, and Pace sign were elicited in all patients. A palpable gluteal mass was found in 8 cases, gluteal atrophy in 5 other patients. The mean piriformis muscle thickness on the diseased side was more than on the healthy side (13.6 ± 3.7 vs 10.9 ± 1.9, (p > 0.05). Common conditions associated with PS were: preceding fall (9, 29 %), overuse of piriformis muscle, lumbar spinal stenosis, fibromyalgia, intra-muscular gluteal injection, blunt trauma over the buttock, leg length discrepancy and use of rear pocket's wallet. CONCLUSIONS: In Bangladesh piriformis syndrome is more common in female, especially among housewives. A fall often precedes the condition. Piriformis syndrome should be considered as possible diagnosis when sciatica occurs without a clear spine pathology.

Piriformis Syndrome in Pre-monsoon, Monsoon, and Winter: An Observational Pilot Study.

INTRODUCTION:  Piriformis syndrome (PS) is a rare focal soft tissue rheumatic disease. Due to heavy rural work, we questioned whether PS was more prevalent in the rainy monsoon than in other seasons. In this pilot research, we studied the pattern of PS, the frequency of PS over the seasons, and whether there were typical preceding events.  Methods: In this time-series descriptive study, PS cases diagnosed in a community-based clinic between January 2018 and December 2019 were enrolled. PS was diagnosed by clinical features and a 50% immediate pain relief from ultrasonogram-guided lidocaine (2%) injection in the piriformis muscle (PM). PS mimics were excluded. RESULTS:  A total of 38 PS cases (11 males) were enrolled consecutively. In 2018, during dry winter (November-February), pre-monsoon (March-May), and rainy monsoon (June-October), nine, seven, and one PS cases were diagnosed, respectively; in 2019, the numbers were three, eight, and seven, respectively. Thus, over two years, 12 PS patients were diagnosed in dry winter, 15 in pre-monsoon, and eight in rainy monsoon. There was no correlation with the type of preceding events. There were no differences in the pattern of PS between the seasons. CONCLUSIONS:  In this pilot study, over two years more new PS cases were observed in the pre-monsoon and dry winter than in the rainy season; this was not supporting our research question. There was no association with specific preceding events.