Piriformis sendromuna ikincil gelişen refleks sempatik distrofi:  Olgu sunumu

Didem Akçalı; Ayça Taş; Pelin Çizmeci; Suna Oktar; Murat Zinnuroğlu; Emre Arslan; Hüseyin Köseoğlu; Avni Babacan

Didem Akçalı^¹, Ayça Taş^¹, Pelin Çizmeci^¹, Suna Oktar^², Murat Zinnuroğlu^³, Emre Arslan^⁴, Hüseyin Köseoğlu^⁴, Avni Babacan^¹

¹Gazi University Faculty Of Medicine, Anesthesiology And Reanimation Department, Algology Department, Ankara
²Gazi University Faculty Of Medicine, Radiology Department, Ankara
³Gazi University Faculty Of Medicine, Physical Therapy And Rehabilitation Department, Ankara
⁴Gazi University Faculty Of Medicine, Internal Medicine Department, Ankara

Keywords: Pain, piriformis injection; piriformis syndrome; reflex sympathetic dystrophy.

Abstract

Piriformis syndrome is a rare cause of hip and foot pain which may be due to sciatic nerve irritation because of anatomic abnormalities of sciatic nerve and piriformis muscle or herniated disc, facet syndrome, trochanteric bursit, sacroiliac joint dysfunction, endometriosis and other conditions where sciatic nerve is irritated. There has been no reflex sympathetic dystrophy (RSD) case presented due to piriformis syndrome before. A sixty-two-year-old female patient had right foot and hip pain (VNS: 8), redness and swelling in the foot since 15 days. Her history revealed long walks and travelling 3 weeks ago and sitting on the foot for a long time for a couple of days. Physical examination revealed painful hip movement, positive straight leg rise. Erythema and hyperalgesia was present in dorsum of the right foot. Right foot dorsiflexion was weak and hyperesthesia was found in right L4-5 dermatome. Medical treatment and ultrasound treatment to piriformis muscle was not effective. The patient was injected 40 mg triamcinolon and local anesthetic in right piriformis muscle under floroscopy by diagnosis of piriformis syndrome, neuropathic pain and RSD. Pain and hyperalgesia resolved and motor weakness was better. During follow-up right foot redness resolved and pain decreased (VNS: 1). In this case report, there was vascular, muscle and skeletal signs supporting RSD, which shows us the therapoetic effect of diagnostic piriformis injection. The patient history, physical examination and diagnostic tests were evaluated by a multidisciplinary team which contributed to the treatment.

BibTex	`@article{ agri509, author = {Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan}, title = {Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu}, journal = {Agri}, year = {2009}, volume = {21}, number = {2}, pages = {75-79}, publisher = {The Turkish Society of Algology} }`
RIS	`TY - JOUR AU - Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan PY - 2009 TI - Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu SP - 75 EP - 79 JO - The Journal of the Turkish Society of Algology J2 - Agri VL - 21 IS - 2 PB - ER -`
EndNote	`%0 Journal Article %A Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan %T Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu %J The Journal of the Turkish Society of Algology %D 2009 %V 21 %N 2 %P 75-79`
APA	Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan (2009). Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu. The Journal of the Turkish Society of Algology, 21(2), 75-79.
MLA	Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan. "Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu" The Journal of the Turkish Society of Algology, vol. 21, no. 2, 2009, pp. 75-79.
Chicago	Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan. "Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu" The Journal of the Turkish Society of Algology 21, no. 2 (2009): 75-79.
AMA	Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan. Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu. Agri. 2009; 21(2): 75-79.
Vancouver	Didem Akçalı, Ayça Taş, Pelin Çizmeci, Suna Oktar, Murat Zinnuroğlu, Emre Arslan, Hüseyin Köseoğlu, Avni Babacan. Piriformis sendromuna ikincil gelişen refleks sempatik distrofi: Olgu sunumu. Agri. 2009; 21(2): 75-79.

Reflex sympathetic dystrophy secondary to piriformis syndrome: a case report

Abstract

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