title: Usefulness of Magnetic Resonance Neurography for Diagnosis of Piriformis Muscle Syndrome and Verification of the Effect After Botulinum Toxin Type A Injection: Two Cases.
abstract: Piriformis muscle syndrome (PMS) is a controversial neuromuscular disorder that is presumed to involve compression neuropathy of the sciatic nerve at the level of the piriformis muscle. Botulinum toxin A (BTX-A) injection into the piriformis muscle is widely used as a treatment aimed at relieving sciatic nerve compression. In 2 patients with PMS, magnetic resonance neurography (MRN) was taken before and after BTX-A injection. The first MRN was performed as a diagnostic tool, and the second to identify the effect of the treatment. Signal change of the sciatic nerve under the hypertrophied piriformis muscle was confirmed by MRN. In follow-up MRN performed after BTX-A injection into the piriformis muscle, changes of the sciatic nerve and piriformis muscle were noticed as well as improvement of clinical symptoms. MRN is a useful tool to add certainty of diagnosis and verify the effect of treatment in PMS.
authors.affiliation: From the Department of Rehabilitation Medicine, Veterans Health Service Medical Center, Department of Rehabilitation Medicine, Seoul, Korea (HEY); Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea (JHP); and Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (SJK).
authors.forename: Hea Eun
authors.initials: HE
authors.lastname: Yang
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: Sungjun
authors.initials: S
authors.lastname: Kim
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D003943:Diagnostic Techniques, Neurological; D006801:Humans; D007273:Injections, Intramuscular; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D055958:Piriformis Muscle Syndrome / Q000175:diagnosis / Q000628:therapy; D011859:Radiography; D012584:Sciatic Nerve / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
chemical_list: D019274:Botulinum Toxins, Type A