Pelvic and Hip Morphometry in Piriformis Syndrome

October 22, 2020 updated by: Fatih Sultan Mehmet Training and Research Hospital

The Importance of Pelvic Morphometric Measurements in Piriformis Syndrome: A Case-control Study

In this case-control study, 23 patients diagnosed as PS by diagnostic injection with ultrasound guidance were selected as the study group. 22 patients who were excluded from the diagnosis of PS and had anteroposterior (AP) direct radiographic imaging were evaluated as the control group. On the AP Pelvic graph, the femoral neck-shaft angle, the distances between predetermined bony landmarks were measured blindly without knowing the diagnosis, and the findings were compared statistically.

This study aims to evaluate whether the anatomical structure of the pelvis predisposes to the etiopathogenesis of the piriformis syndrome.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Piriformis syndrome (PS) is a neuromuscular disorder consisting of pain and symptoms caused by compression of the sciatic nerve and other structures that pass under the piriformis muscle (PM). Due to difficulties in diagnosis, PS is confused with other pathologies such as lumbar disc pathology, lumbosacral radiculopathy, and sacroiliac dysfunction. As a result, patients are exposed to unnecessary and ineffective treatments, even surgery. The main problems in the PS diagnosis are the absence of objective physical examination findings, radiological findings, and a clear etiology. When the pathophysiology and etiology of PS are considered, there is no identifiable cause in most patients. Previous studies suggest that trauma, anatomical variations, and the trigger point in the muscle may cause PS. No study in the literature radiologically examined the pelvis or hip bone morphological features in PS to the best of our knowledge. This study aims to determine whether pelvic or hip bone morphology features pose a risk for PS in this study.

Study Type

Observational

Enrollment (Actual)

45

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Istanbul, Turkey, 34752
        • fatih sultan mehmet research and traning hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The physical medicine and rehabilitation outpatient clinic of Fatih Sultan Mehmet Training and Research Hospital

Description

For Piriformis syndrome group (study group);

Inclusion Criteria:

  • A dramatic relief of pain following piriformis muscle local anesthetic injection

Exclusion Criteria:

  • Having a neurological deficiency
  • Having lumbar, sacroiliac, hip, and thoracolumbar pathology (inflammatory or degenerative)
  • Operation history at the lumbar and hip region
  • Being in the gestational or lactational period
  • Body mass index of greater than 35
  • History of inflammatory or infectious disease
  • Active psychiatric illness, severe systemic, vascular or malign disease

For the control group

Inclusion criteria:

-Having Anteroposterior pelvic radiographs for other medical reasons

Exclusion criteria:

  • Having a present piriformis syndrome or a history of piriformis syndrome
  • Having a neurological deficiency
  • Having lumbar, sacroiliac, hip, and thoracolumbar pathology (inflammatory or degenerative)
  • Operation history at the lumbar and hip region
  • Being in the gestational or lactational period
  • Body mass index of greater than 35
  • History of inflammatory or infectious disease
  • Active psychiatric illness, severe systemic, vascular or malign disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Piriformis syndrome group
Patients who were diagnosed as PS by diagnostic injection with ultrasound guidance
Diagnostic test: Ultrasound guided diagnostic injection
4 cc lidocaine %2 injection into the piriformis muscle was performed for the diagnosis of piriformis syndrome. It was performed by the ultrasound-guidance to increase the accuracy of the injection.
Age and sex match control group
Patients who were excluded from the diagnosis of PS and had anteroposterior (AP) direct radiographic imaging

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Femoral Neck-Shaft Angle (NSA)
Time Frame: The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
The NSA, also called caput collum-diaphyseal angle or inclination angle, defined as the angle between the longitudinal femoral shaft axis and femoral head-neck axis.
The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
Posterior Superior Iliac Spine (PSIS)- Trochanter Major (TM)
Time Frame: The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
The distance between the posterior superior iliac spine and the greater trochanter
The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
PSIS-Ischial Tuberosity (IT)
Time Frame: The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
The distance between the posterior superior iliac spine and the apex of the ischial tuberosity
The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
IT-TM
Time Frame: The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
The distance between the apex of the ischial tuberosity and the greater trochanter
The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
Sacrum-TM
Time Frame: The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.
The distance between the sacrum and the greater trochanter
The measurement was evaluated by two different investigators immediately after the pelvis anteroposterior radiography was taken.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Fatih Sultan Mehmet Training and Research Hospital

Investigators

  • Study Director: Gamze Güleç, MD, Fatih Sultan Mehmet Training and Research Hospital
  • Study Director: Ilknur Aktas, MD, Fatih Sultan Mehmet Training and Research Hospital
  • Study Chair: Feyza Unlu Ozkan, MD, Fatih Sultan Mehmet Training and Research Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 20, 2018

Primary Completion (Actual)

March 18, 2020

Study Completion (Actual)

June 18, 2020

Study Registration Dates

First Submitted

October 18, 2020

First Submitted That Met QC Criteria

October 22, 2020

First Posted (Actual)

October 23, 2020

Study Record Updates

Last Update Posted (Actual)

October 23, 2020

Last Update Submitted That Met QC Criteria

October 22, 2020

Last Verified

September 1, 2020

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FSMEAH

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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