achilles
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A patient complains to a physician of chronic pain and tingling of the buttocks. The pain is exacerbated when the buttocks are compressed by sitting on a toilet seat or chair for long periods. No lumbar pain is noted. Pain is elicited when the physician performs Freiberg's maneuver, in which there is a forceful internal rotation of the extended thigh. Which of the following is the most likely diagnosis?
A. Disk compression of the sciatic nerve
B. Fibromyalgia
C. Piriformis syndrome
D. Popliteus tendinitis
E. Posterior femoral muscle strain
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| Jinx
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| sachida
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C- piriformis syndrome.
Read this: "The condition is caused by the irritation or compression of the proximal sciatic nerve by the piriformis muscle, which at the sacral vertebrae, runs through the sciatic notch and inserts at the greater trochanter of the femur. The piriformis muscle is used to help rotate the leg outwards.
It is particularly common among skiers, tennis players, long-distance bikers, and truck drivers. In addition, in as much as 20% of the population, the sciatic nerve passes through the piriformis muscle, contributing to the development of the condition."
Source: http://www.answers.com/topic/piriformis-syndrome
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| sachida
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I beleive forceful internal rotation wil stretch the piriformis muscle thus causing severe pain through sciatic nerve compression.
Diagnosis: by exclusion
Treatment: avoid activity that aggrevate the pain (doc it hurts- dont do it!!
Other therapy: physiotherapy to strengthen hib abductor and relax priformis, NSAIDs and Steroid inj in priformis near sciatic nerve (be careful with that!!!))
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| achilles
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thats right. the answer is c-piriformis syndrome.
good explanation sachida. gr8 
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