Complementary Specific Pelvic Sequences on Routine Lumbar Magnetic Resonance Imaging Scans: An Imaging-Based Study...

Area of Science:

• Radiology
• Orthopedics
• Neurology

Background:

• Piriformis syndrome (PS) is often a clinical diagnosis, leading to potential underdiagnosis.
• Routine lumbar MRI may not sufficiently evaluate the piriformis muscle and sciatic nerve for PS.
• Early and accurate diagnosis of PS is crucial for effective patient management.

Purpose of the Study:

• To assess the value of specific pelvic MRI sequences as an adjunct to lumbar MRI for piriformis syndrome detection.
• To determine the frequency of piriformis syndrome in patients undergoing radiological evaluation.
• To optimize diagnostic protocols for piriformis syndrome.

Main Methods:

• Retrospective analysis of patients undergoing lumbar MRI, with a subset also receiving pelvic MRI.
• Exclusion of high-energy trauma cases.
• Review of electronic patient records and imaging (MRI, MRN) for demographics and radiological features.

Main Results:

• Out of 1321 lumbar MRIs, 485 underwent pelvic MRI. Forty patients (8.2%) were diagnosed with PS, confirmed by MR neurography (MRN).
• Specific pelvic MRI sequences, when added to lumbar MRI, accurately delineated piriformis muscle pathology and sciatic nerve abnormalities.
• The overall frequency of PS was 3.03% in the study population.

Conclusions:

• Specific pelvic MRI sequences integrated with lumbar MRI enhance the early detection of piriformis syndrome.
• This imaging approach can identify patients with PS who were not initially suspected clinically.
• Optimized MRI protocols can improve diagnostic yield for piriformis syndrome.