AB172. SOH24AB_026. Ultrasound-guided piriformis hydrodissection

Background: Lower limb radicular pain in the lower limbs is a frequently encountered issue followed by tailored treatment leads to the most favourable results.

Methods: Case report.

Results: We present the inaugural account of an ultrasound-guided piriformis hydrodissection method used for diagnosing and treating lower limb radicular pain. This hydrodissection technique involves an ultrasound-guided injection procedure focused on separating a fascial plane in areas with significant neural innervation. A 40-year-old female patient with a history of lumbar discectomy sought medical attention due to persistent right lower limb radicular pain. Her pain had not responded to pharmaceutical treatment or physiotherapy. The patient displayed tenderness in the gluteal region and tested positive for piriformis stretch discomfort. Sonographic evaluation revealed calcification in the superficial piriformis fascia. Consequently, we conducted a barbotage and hydrodissection procedure targeting the superficial piriformis muscle. Remarkably, four weeks following the intervention, the patient reported complete relief from her symptoms.

Conclusions: The method has the potential to assist in addressing lower limb radicular pain linked to the piriformis muscle. Optimal results are achieved when the condition is accurately diagnosed and treated accordingly.

Keywords: Diagnosis; piriformis muscle; radicular pain; technique; ultrasound