Piriformis syndrome in an incomplete paraplegic patient: a case report

Abstract

Objectives: we present an incomplete paraplegic patient with lower back and hip pain, diagnosed and treated as the piriformis syndrome (PS). Setting: University hospital, Turkey. Case: a 62-year-old woman with T3 paraplegia of American Spinal Injury Association Impairment Scale grade D presented with lower back and right hip pain accompanied by pain and numbness radiating to her right leg. After detailed anamnesis and physical examination, she was pre-diagnosed as having PS. The marked relief of pain following the ultrasound-guided piriformis muscle injection of 4 cc of lidocaine 2%+1 cc of betametazone confirmed the diagnosis. Conclusion: although the compressive neuropathies and musculoskeletal injuries of the upper limb leading to neuropathic and musculoskeletal pain in persons with spinal cord injury (SCI) are well described in literature, there is limited information regarding those of lower limbs. To the best of our knowledge, this is the first reported case of PS in a patient with SCI. PS should be kept in mind as a pain generator, especially in active and ambulatory SCI patients.