Pace J B, Nagle D
West J Med. 1976 Jun;124(6):435-9.
Among a variety of deep muscle trigger points, the piriform muscle trigger point is selected for individual scrutiny. This seems fully justified by the great potential for confusing this entity with discogenic disease and consequently having unnecessary surgical procedures carried out.The diagnosis can be made from findings on simple physical diagnostic tests and an appropriate history. Low back and hip pain with pain radiating down the back of the leg should suggest piriform syndrome as part of the differential diagnosis. This is especially true if a female patient has complaint of dyspareunia. Pain and weakness on resisted abduction-external rotation of the thigh is a sign of piriform syndrome. This is confirmed by tenderness and reproduction of the patient's complaints by digital pressure over the belly of the piriform muscle, completing the diagnostic criteria. Local injection of the muscle belly is curative. There are no laboratory or x-ray findings leading to a diagnosis.
在各种深部肌肉触发点中，梨状肌触发点被选出来进行单独研究。由于该病症极有可能与椎间盘源性疾病混淆，进而导致不必要的外科手术，所以这样做似乎完全合理。诊断可依据简单体格诊断测试结果及恰当的病史做出。下背部和臀部疼痛，并伴有沿腿部后侧放射的疼痛，在鉴别诊断时应考虑梨状肌综合征。如果女性患者主诉性交困难，情况尤其如此。大腿抗外展-外旋时疼痛和无力是梨状肌综合征的体征。通过对梨状肌肌腹进行指压，出现压痛并引发患者的相同主诉，即可证实该体征，从而完善诊断标准。对肌腹进行局部注射可治愈该病。没有可用于诊断的实验室检查结果或X光检查结果。
