A Swollen Inferior Gemellus Muscle with Hematoma Mimics Sciatica-A Case Report

Area of Science:

• Orthopedics
• Radiology
• Pain Management

Background:

• Sciatic pain often stems from spinal issues, but extra-spinal origins, like pelvic muscle dysfunction, are frequently overlooked.
• Pyriformis syndrome is a known cause, yet other deep pelvic muscles contributing to sciatic pain are underdiagnosed.

Observation:

• This case details a swollen inferior gemellus muscle with hematoma.
• Initial diagnosis was via ultrasonography, with confirmation through magnetic resonance imaging (MRI).

Findings:

• Ultrasound identified a swollen inferior gemellus muscle with a hematoma.
• MRI revealed edematous changes and enhanced signal within the right inferior gemellus muscle.
• While ultrasound can detect inferior gemellus pathology, its deep location makes it challenging to visualize.

Implications:

• Inferior gemellus muscle pathology should be considered in cases of unexplained sciatic pain.
• MRI offers superior visualization for deep pelvic muscle pathologies like inferior gemellus hematoma.
• Accurate diagnosis of rare extra-spinal sciatic pain sources can improve patient outcomes.