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The “piriformis syndrome”— myth or reality?
  1. M T F Read
  1. 7 Waterden Road, Guildford, Surrey GU24 0LX, UK

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In the above editorial,1 I noted the desire to package these rather indeterminate pains in the buttock, around the trochanter, and which can radiate to the groin or knee, as a deep gluteal syndrome. The pririformis syndrome and the hamstring syndrome2 do I believe exist, but in my admittedly very small experience, as they are rare, they do have a major clinical finding that differs from pain induced by the hip stabilisers. Because the sciatic nerve is involved, the straight leg raise, Laseque and Bowstring signs, which produce neural stress peripheral to the lesion, are positive, but the slump test, which moves the dura and is proximal to the lesion, is negative. Most patients diagnosed as having “piriformis syndrome” do not have these clinical findings, and their problem better fits the classification of deep gluteal syndrome. Perhaps, in fact, the deep gluteal syndrome diagnosis should be used as well as, and not inclusive of, the piriformis and hamstring syndromes. I feel the gluteals are often not involved and perhaps an even broader term such as hip stabiliser syndrome should be considered.