Piriformissyndrom - kritische Beurteilung der Literatur und Diskussion der klinischen Zusammenhänge[1]

Zusammenfassung

Die vorliegende Arbeit liefert einen Überblick und eine kritische Analyse der Literatur zum Piriformissyndrom (PS). Das PS gilt mehrheitlich als Engpasssyndrom des N. ischiadicus im Foramen infrapiriforme, verursacht durch pathologische Veränderungen des M. piriformis. Die Diagnosenstellung erfolgt primär klinisch. Das am häufigsten beschriebene Symptom ist Gesäßschmerz, gefolgt von Schmerzen in der Oberschenkelrückseite und bei Palpation der tiefen Gesäßmuskeln. Für die eigens zur Diagnostik des PS entwickelten Tests gibt es keine kritische Evaluation. An der Schmerzentstehung könnten weitere Muskeln im dorsalen Becken wie der M. obturatorius internus beteiligt sein. Die nach Sacketts [52] Evidenzpyramide bewertete Qualität der Studien ist größtenteils gering.

Abstract

This article presents an overview and a critical analysis of the literature concerning the piriformis syndrome (PS). PS is generally considered as an entrapment syndrome of the sciatic nerve in the infrapiriform foramen caused by pathologic alterations of the piriform muscle. Diagnosis is mainly carried out clinically. The most frequently described symptom is buttock pain followed by pain in the posterior thigh and on palpation of the deep gluteal muscles. There exists no critical evaluation of the tests specifically developed for the diagnosis of PS. Other muscles such as the obturatorius internus muscle could possibly also be involved in the development of pain. The studies were assessed by Sackett’s [52] evidence pyramid and were mostly found to be of low quality.

Schlüsselwörter

Piriformissyndrom - Ischialgie - Gesäßschmerz - Pelvic-outlet-Syndrom

Key words

Piriformis syndrome - ischialgia - buttock pain - pelvic entrapment syndrome

1 Abschlussarbeit der DVMT-OMT-Ausbildung 2003 - 2005.

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1 Abschlussarbeit der DVMT-OMT-Ausbildung 2003 - 2005.