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An Unusual Presentation of Right-Sided Sciatica with Foot Drop.

McCabe FJ, McCabe JP - Case Rep Orthop (2016)

Bottom Line: By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica.Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect.In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, NUI Galway, Galway, Ireland.

ABSTRACT
Rarely, sciatica is of extraspinal aetiology. By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica. Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect. In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.

No MeSH data available.


Related in: MedlinePlus

Oblique parasagittal section of T2-weighted MRI displaying passage of the right sciatic nerve above the piriformis muscle. (1) Sciatic nerve. (2) Piriformis. (3) Sacroiliac joint. (4) Ischium. (5) Ischial tuberosity.
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fig3: Oblique parasagittal section of T2-weighted MRI displaying passage of the right sciatic nerve above the piriformis muscle. (1) Sciatic nerve. (2) Piriformis. (3) Sacroiliac joint. (4) Ischium. (5) Ischial tuberosity.

Mentions: The right hip exploration exposed gross swelling and dullness of colour of the piriformis muscle and the gemelli-obturator internus complex. The sciatic nerve was explored back to the greater sciatic foramen to show both peroneal and tibial roots of the sciatic nerve exiting together above the piriformis muscle (Figure 3), one of the rarest anatomical variations [2]. The nerve itself was extremely tight, with an exceptionally broad diameter (Figure 4). The nerve was decompressed (Figure 5) and the piriformis and conjoint tendon were biopsied for histopathological analysis. Upon analysis, both samples showed identical type II muscle fibre atrophy, suggestive of chronic muscle denervation without reinnervation. There was no evidence of myositis or dystrophy. The man was discharged 3 days later.


An Unusual Presentation of Right-Sided Sciatica with Foot Drop.

McCabe FJ, McCabe JP - Case Rep Orthop (2016)

Oblique parasagittal section of T2-weighted MRI displaying passage of the right sciatic nerve above the piriformis muscle. (1) Sciatic nerve. (2) Piriformis. (3) Sacroiliac joint. (4) Ischium. (5) Ischial tuberosity.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4863079&req=5

fig3: Oblique parasagittal section of T2-weighted MRI displaying passage of the right sciatic nerve above the piriformis muscle. (1) Sciatic nerve. (2) Piriformis. (3) Sacroiliac joint. (4) Ischium. (5) Ischial tuberosity.
Mentions: The right hip exploration exposed gross swelling and dullness of colour of the piriformis muscle and the gemelli-obturator internus complex. The sciatic nerve was explored back to the greater sciatic foramen to show both peroneal and tibial roots of the sciatic nerve exiting together above the piriformis muscle (Figure 3), one of the rarest anatomical variations [2]. The nerve itself was extremely tight, with an exceptionally broad diameter (Figure 4). The nerve was decompressed (Figure 5) and the piriformis and conjoint tendon were biopsied for histopathological analysis. Upon analysis, both samples showed identical type II muscle fibre atrophy, suggestive of chronic muscle denervation without reinnervation. There was no evidence of myositis or dystrophy. The man was discharged 3 days later.

Bottom Line: By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica.Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect.In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, NUI Galway, Galway, Ireland.

ABSTRACT
Rarely, sciatica is of extraspinal aetiology. By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica. Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect. In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.

No MeSH data available.


Related in: MedlinePlus