Department of Health Research Methods, Evidence, and Impact, McMaster University, 1200 Main St. W, Hamilton, ON, L8N 3Z5, Canada.
Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3354-3364. doi: 10.1007/s00167-020-05966-x. Epub 2020 Apr 3.
Clinicians are not confident in diagnosing deep gluteal syndrome (DGS) because of the ambiguity of the DGS disease definition and DGS diagnostic pathway. The purpose of this systematic review was to identify the DGS disease definition, and also to define a general DGS diagnostic pathway.
A systematic search was performed using four electronic databases: PubMed, MEDLINE, EMBASE, and Google Scholar. In eligibility criteria, studies in which cases were explicitly diagnosed with DGS were included, whereas review articles and commentary papers were excluded. Data are presented descriptively.
The initial literature search yielded 359 articles, of which 14 studies met the eligibility criteria, pooling 853 patients with clinically diagnosed with DGS. In this review, it was discovered that the DGS disease definition was composed of three parts: (1) non-discogenic, (2) sciatic nerve disorder, and (3) nerve entrapment in the deep gluteal space. In the diagnosis of DGS, we found five diagnostic procedures: (1) history taking, (2) physical examination, (3) imaging tests, (4) response-to-injection, and (5) nerve-specific tests (electromyography). History taking (e.g. posterior hip pain, radicular pain, and difficulty sitting for 30 min), physical examination (e.g. tenderness in deep gluteal space, pertinent positive results with seated piriformis test, and positive Pace sign), and imaging tests (e.g. pelvic radiographs, spine and pelvic magnetic resonance imaging (MRI)) were generally performed in cases clinically diagnosed with DGS.
Existing literature suggests the DGS disease definition as being a non-discogenic sciatic nerve disorder with entrapment in the deep gluteal space. Also, the general diagnostic pathway for DGS was composed of history taking (posterior hip pain, radicular pain, and difficulty sitting for 30 min), physical examination (tenderness in deep gluteal space, positive seated piriformis test, and positive Pace sign), and imaging tests (pelvic radiographs, pelvic MRI, and spine MRI). This review helps clinicians diagnose DGS with more confidence.
IV.
由于深臀肌综合征 (DGS) 的疾病定义和 DGS 诊断途径不明确，临床医生对其诊断缺乏信心。本系统评价的目的是确定 DGS 的疾病定义，并定义一个通用的 DGS 诊断途径。
使用四个电子数据库（PubMed、MEDLINE、EMBASE 和 Google Scholar）进行系统搜索。在纳入标准中，纳入了明确诊断为 DGS 的病例研究，排除了综述文章和评论文章。数据以描述性方式呈现。
最初的文献搜索产生了 359 篇文章，其中 14 项研究符合纳入标准，共纳入 853 例临床诊断为 DGS 的患者。在本综述中，发现 DGS 的疾病定义由三部分组成：（1）非椎间盘源性，（2）坐骨神经障碍，（3）神经在深臀肌间隙内受压。在 DGS 的诊断中，我们发现了五个诊断程序：（1）病史采集，（2）体格检查，（3）影像学检查，（4）注射反应，（5）神经特异性检查（肌电图）。病史采集（如后髋疼痛、神经根痛和坐 30 分钟困难）、体格检查（如深臀肌间隙压痛、坐位梨状肌试验阳性结果和阳性 Pace 征）和影像学检查（如骨盆 X 线片、脊柱和骨盆磁共振成像（MRI））通常用于临床诊断为 DGS 的病例。
现有文献表明，DGS 的疾病定义为非椎间盘源性坐骨神经障碍伴深臀肌间隙受压。此外，DGS 的一般诊断途径包括病史采集（后髋疼痛、神经根痛和坐 30 分钟困难）、体格检查（深臀肌间隙压痛、坐位梨状肌试验阳性和 Pace 征阳性）和影像学检查（骨盆 X 线片、骨盆 MRI 和脊柱 MRI）。本综述有助于临床医生更有信心地诊断 DGS。
IV。
