Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung Medical University, Kaohsiung, Taiwan
Clin Med (Lond). 2020 May;20(3):e18-e19. doi: 10.7861/clinmed.2020-0035.
Piriformis syndrome refers to sciatica symptoms that do not originate from spinal root compression, but involve the overlying piriformis muscle. Diagnosis is clinical since there are no definitive tests to confirm the diagnosis. Piriformis syndrome is often misinterpreted as sciatica or other pains. Rarely, it could be one of the manifestations of pelvic osteomyelitis. Pelvic osteomyelitis is rare in adults, but it is associated with high morbidity and mortality. One of the severe complications is bacteraemia, which is life-threatening and may be associated with poor outcome. Acute pelvic osteomyelitis is often not initially diagnosed owing to its non-specific symptoms, including fever and severe but poorly localised pain, which may result in a delay of appropriate treatment. Thus, prompt diagnosis is crucial to the prognosis. Here, we report a patient suffering from acute pelvic osteomyelitis with piriformis syndrome as the only initial manifestation without fever. This unusual manifestation rendered prompt and correct diagnosis difficult.
梨状肌综合征是指坐骨神经痛症状并非源于神经根受压，而是涉及上方的梨状肌。由于没有明确的测试来确认诊断，因此诊断是临床的。梨状肌综合征常被误诊为坐骨神经痛或其他疼痛。很少见的情况下，它可能是骨髓炎的一种表现。成人骨髓炎很少见，但发病率和死亡率很高。严重的并发症之一是菌血症，这是危及生命的，可能与不良预后有关。急性骨髓炎由于其非特异性症状，包括发热和严重但定位不佳的疼痛，通常在最初无法诊断，这可能导致治疗延迟。因此，及时诊断对预后至关重要。在这里，我们报告了一例急性骨髓炎患者，其唯一的初始表现为梨状肌综合征，没有发热。这种不寻常的表现使得及时和正确的诊断变得困难。
