Wyant G M
Can Anaesth Soc J. 1979 Jul;26(4):305-8. doi: 10.1007/BF03006291.
The piriformis is a deep-seated muscle, most of its muscular portion being part of the dorsal wall of the pelvis. The lateral portion and its insertion is extra-pelvic and lies deep to the glutei. Like more superficially located and therefore more easily accessible skeletal muscles, the piriformis too can be the seat of trigger points, giving rise to symptoms indistinguishable from those of other causes of low backache, unless a deliberate search is made for the signs specific to the piriformis syndrome. Having made a presumptive diagnosis, confirmation is gained by palpating the muscle itself via rectum or vagina and reproducing the pain by digital pressure. If this test also is positive, the muscle is injected, the approach being either through the sciatic notch, from the perineum, or through the vagina. Immediate relief of pain is experienced after the solution of local anaesthetic and steroid has been deposited deep within the fleshy portion of the muscle.
梨状肌是一块深层肌肉，其大部分肌腹是骨盆后壁的一部分。外侧部分及其止点位于盆腔外，在臀肌深面。与位置较浅因而更容易触及的骨骼肌一样，梨状肌也可能存在触发点，引发与其他腰痛原因难以区分的症状，除非特意查找梨状肌综合征的特定体征。做出初步诊断后，通过经直肠或阴道触诊肌肉本身并通过指压再现疼痛来进行确认。如果该检查也呈阳性，则对肌肉进行注射，注射途径可以是经坐骨切迹从会阴进入，也可以经阴道进入。在将局部麻醉剂和类固醇溶液注入肌肉的肉质部分深处后，疼痛会立即缓解。
