title: Piriformis syndrome: a case series of 31 Bangladeshi people with literature review.
abstract: OBJECTIVE
  To describe a series of piriformis syndrome patient among Bangladesh people with literature review.
  
  
  METHODS
  Consecutive 31 piriformis syndrome patients were enrolled. Besides history and clinical examination, piriformis muscle thickness was also measured with diagnostic ultrasound (3.5 MHZ). MRI of lumbar spine, X-rays of lumbo-sacral spine, and pelvis were performed in all patients. Statistical Package for the Social Sciences (SPSS), Windows 8.0, was used for statistical calculation, and univariate analysis of primary data was done. Data present with frequency table. For literature review concerning piriformis syndrome we used Embase, Pubmed, Medline, and Cochrane database.
  
  
  RESULTS
  A total of 31 patients (21 female) with PS were enrolled, 21 housewives. Mean age 42.2 ± 14.5 years. All presented with buttock pain, aggravating with long sitting (31), lying on the affected side (31), during rising from a chair(24), and forward bending (28). Six reported pain improvement while walking. Gluteal tenderness, positive FAIR test, and Pace sign were elicited in all patients. A palpable gluteal mass was found in 8 cases, gluteal atrophy in 5 other patients. The mean piriformis muscle thickness on the diseased side was more than on the healthy side (13.6 ± 3.7 vs 10.9 ± 1.9, (p > 0.05). Common conditions associated with PS were: preceding fall (9, 29 %), overuse of piriformis muscle, lumbar spinal stenosis, fibromyalgia, intra-muscular gluteal injection, blunt trauma over the buttock, leg length discrepancy and use of rear pocket's wallet.
  
  
  CONCLUSIONS
  In Bangladesh piriformis syndrome is more common in female, especially among housewives. A fall often precedes the condition. Piriformis syndrome should be considered as possible diagnosis when sciatica occurs without a clear spine pathology.
authors.affiliation: Physical Medicine and Rehabilitation Department, Feni Diabetes Hospital, Feni, Bangladesh. abusiddiq37@yahoo.com.
authors.forename: Md Abu Bakar
authors.initials: MA
authors.lastname: Siddiq
authors.affiliation: Physical Medicine and Rehabilitation Department, Chittagong Medical College Hospital, Chittagong, Bangladesh.
authors.forename: Md Shawkat
authors.initials: MS
authors.lastname: Hossain
authors.affiliation: Physical Medicine and Rehabilitation Department, Chittagong Medical College Hospital, Chittagong, Bangladesh.
authors.forename: Mohammad Moin
authors.initials: MM
authors.lastname: Uddin
authors.affiliation: Biochemistry and Biotechnology Department, University of Science and Technology Chittagong (USTC), Chittagong, Bangladesh.
authors.forename: Israt
authors.initials: I
authors.lastname: Jahan
authors.affiliation: Physical Medicine and Rehabilitation Department, BSMMU, Dhaka, Bangladesh.
authors.forename: Moshiur Rahman
authors.initials: MR
authors.lastname: Khasru
authors.affiliation: Bangladesh Institute of Ultrasound in Medicine and Research, Dhaka, Bangladesh.
authors.forename: Neaz Mahmud
authors.initials: NM
authors.lastname: Haider
authors.affiliation: Rheumatology Department, Faculty of Behavioural Sciences, University of Twente, 7500 AE, Enschede, The Netherlands.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Rasker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000208:ethnology; D002081:Buttocks; D005260:Female; D006796:Household Work; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000208:ethnology / Q000209:etiology; D055958:Piriformis Muscle Syndrome / Q000208:ethnology* / Q000209:etiology; D011187:Posture / Q000502:physiology; D012423:Rural Health; D014504:Urban Health; D016138:Walking / Q000502:physiology; D055815:Young Adult
keywords: Bangladeshi people; Case series; Piriformis syndrome