• Title/Summary/Keyword: piriformis

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Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Correction of late adolescent skeletal Class III using the Alt-RAMEC protocol and skeletal anchorage

  • Muhammed Hilmi Buyukcavus;Omer Faruk Sari;Yavuz Findik
    • The korean journal of orthodontics
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    • v.53 no.1
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    • pp.54-64
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    • 2023
  • This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (AltRAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

  • Kim, Hyung Tae;Kim, Sae Young;Byun, Gyung Jo;Shin, Byung Chul;Lee, Jin Young;Choi, Eun Joo;Choi, Jong Bum;Hong, Ji Hee;Choi, Seung Won;Kim, Yeon Dong
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.287-295
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    • 2017
  • Background: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results: Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions: Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management.

Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures

  • Kim, Yeong Uk;Cho, Jae Ho;Song, Phil Hyun
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.337-340
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    • 2020
  • Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve

  • Kim, Young Je;Kim, Du Hwan
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.148-151
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    • 2021
  • Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

A Study on Muscular System of Foot Three Yang Meridian-Muscle (족삼양경근(足三陽經筋)의 근육학적(筋肉學的) 고찰(考察))

  • Lee, Myung-Sun;Hong, Seung-Won;Lee, Sang-Ryong
    • Korean Journal of Acupuncture
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    • v.25 no.2
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    • pp.1-32
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    • 2008
  • Objectives : This study was performed to understand the interrelation between 'Foot three yang meridian-muscle' and 'muscular system'. Methods : We have researched some of the literatures on Meridian-muscle theory, anatomical muscular system, myofascial pain syndrome and anatomy trains. And especially we have compared myofascial pain syndrome to anatomy trains and researched what kind of relationship is exist between them. Results : It is considered that Foot taeyang meridian-muscle includes Abductor digiti minimi m., Gastrocnemius m., Biceps femoris m., Longissimus m., Omohyoid m., Occipital m., Frontal m., Orbicularis oculi m., Trapezius m., Sternocleidomastoid m., Sternohyoid m., Zygomaticus m. Foot soyang meridian-muscle includes Dorsal interosseus m., Tendon of extensor digitorum longus m., Extensor digitorum longus m., Iliotibial band, Vastus lateralis m., Piriformis m., Tensor fasciae latae m., Internal abdominal oblique m., External abdominal oblique m,, Internal intercostal m., External intercostal m., Pectoralis major m., Sternocleidomastoid m., Posterior auricular m., Temporal m., Masseter m., Orbicularis oculi m. Foot yangmyung meridian-muscle includes Extensor digitorum longus m., Vastus lateralis m., Iliotibial band, Iliopsoas m., Anterior tibial m., Rectus femoris m., Sartorius m., Rectus abdominis m., Pectoralis major m., Internal intercostal m., External intercostal m., Sternocleidomastoid m., Masseter m., Levator labii superioris m., Zygomatic major m., Zygomatic minor m., Orbicularis oculi m., Buccinator m. and the symptoms of Foot three yang meridian-muscle are similar to the myofascial pain syndrome. Superficial back line in anatomy trains is similar to the pathway of Foot taeyang meridian-muscle. Lateral Line in anatomy trains is similar to the pathway of Foot soyang meridian-muscle. Superficial Front Arm Line in anatomy trains is similar to the pathway of Foot yangmyung meridian-muscle. Conclusions : There is some difference between myofascial pain syndrome and meridian-muscle theory in that the former explains each muscle individually, while the latter classifies muscular system in the view of integrated organism. More studies are needed in anatomy and physiology to support the integration of muscular system of Foot three yang meridian-muscle in aspect of anatomy trains.

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Study on Muscular System about Gall Bladder Channel of Foot Soyang Muscle (족소양담경근(足少陽膽經筋)에 대한 근육학적 고찰)

  • Ryu, Hyung-Sun;Kang, Jung-Soo
    • Journal of Acupuncture Research
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    • v.22 no.5
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    • pp.29-36
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    • 2005
  • Objectives : This study is performed to understand the interrelation between 'Foot soyang muscle of the Gall bladder channel' and 'muscular system' on the basis of the link between meridian muscle theory and myofascial pain syndrome. Methods : We have researched some of oriental medical books about meridian muscle theory and western medical books about anatomical muscular system. Results & Conclusion : 1. Myofascial pain syndrome is the medical treatment which finds the start point of the pain in fascia and then treats it on the basis of object and concrete anatomical theory, so its application is needed for objectification of the oriental medicine. 2. There is a wide difference between myofascial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. Foot soyang muscle contains Dorsal interosseous m, Extensor digitorum longus m, Musculus peroneus brevis, longus and, tertius, lliotibial tract, Vastus lateralis m, Gluteus m, Aximus m, Piriformis m, Tensor fasciae latae m, Gluteus minimus m, Obliquus internus & externus abdominis m, External & Internal intercostal m, Serratus anterior m, Pectoralis major m, Sternocleidomastoid m, Auricularis posterior m, Temporalis m, Masseter m, Orbicularis oculi m etc. on the basis of function and the nature of a disease reflected in muscle. 4. Foot soyang muscle keeps the balance of left md right of the body on the outside, while the Gall bladder keeps the balance of the JangBuKiHyeul(臟腑氣血) on the inside.

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Arthrodesis of the Knee Using a Retrograde Femoral Intramedullary Nail: Technical Report (역행성 대퇴부 골수강 내 금속정을 이용한 슬관절 고정술: 술기 보고)

  • Wang, Lih;Kim, Sun Hyo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.183-189
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    • 2021
  • Arthrodesis is one of the last options available to obtain a stable, painless knee in patients who are unable to undergo reconstructive surgery due to a damaged knee joint. A variety of techniques have been used, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Another option is the use of a short nail such as the Neff nail, the Wichita nail, or the Huckstep nail, but there are no commercial short nails available for use in Korea. This technical report describes a technique for knee arthrodesis using a retrograde femoral intramedullary nail.