Siow Co Yih, Chen Kuan-Lin
Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua 500209, Taiwan.
Department of Physical Medicine and Rehabilitation, Yuanrung Hospital Yuansheng Branch, Changhua County 510007, Taiwan.
Diagnostics (Basel). 2022 Apr 26;12(5):1080. doi: 10.3390/diagnostics12051080.
Extra-spinal causes of sciatic pain are normally underdiagnosed, as they are extremely uncommon. Although pyriformis syndrome is recognized as one of the main causes of sciatic pain, other pelvic muscles that could cause sciatic pain are often overlooked. The present article describes a swollen inferior gemellus muscle with hematoma initially diagnosed with ultrasonography and later confirmed with magnetic resonance imaging (MRI) scan. Ultrasound revealed a swollen muscle with hematoma between the ischial tuberosity and the medial surface of the greater trochanter of the femur. MRI scan showed edematous change with an increased enhancement of the right inferior gemellus muscle. Ultrasound could be used to diagnose inferior gemellus pathology, but the muscle is easy to miss. Therefore, MRI could be preferred for conditions that impact deep or large areas in confirming inferior gemellus pathology.
坐骨神经痛的脊柱外病因通常诊断不足，因为它们极为罕见。尽管梨状肌综合征被认为是坐骨神经痛的主要病因之一，但其他可能导致坐骨神经痛的盆腔肌肉常常被忽视。本文描述了一例下孖肌肿胀伴血肿的病例，最初通过超声诊断，后来经磁共振成像（MRI）扫描得以证实。超声显示在坐骨结节与股骨大转子内侧面之间有一块肿胀且伴有血肿的肌肉。MRI扫描显示右侧下孖肌有水肿改变且强化增强。超声可用于诊断下孖肌病变，但该肌肉容易被漏诊。因此，对于影响深部或大面积区域的情况，在确诊下孖肌病变时，MRI可能更具优势。
