Jump to content

Piriformis muscle: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous edit
Content deleted Content added
VisualWikitext
Monkbot (talk | contribs)
Bots
3,119,770 edits
m Task 18 (cosmetic): eval 4 templates: del empty params (1×); hyphenate params (2×);
m Giving piriformis syndrome its own heading under clinical significance
 
(23 intermediate revisions by 11 users not shown)
Line 1: Line 1:
{{short description|One of six small hip muscles in the lateral rotator group}}
{{Short description|Hip muscle in the lateral rotator group}}
{{Infobox muscle
{{Infobox muscle
| Name = Piriformis muscle
| Name = Piriformis muscle
| Latin = Musculus piriformis
| Latin = musculus piriformis
| Image = Piriformis.jpg
| Image = Piriformis.jpg
| Caption = Buttocks seen from behind (the piriformis and the rest of the [[lateral rotator group]] are visible)
| Caption = Buttocks seen from behind (the piriformis and the rest of the [[lateral rotator group]] are visible)
| Image2 = Sobo 1909 298.png
| Image2 = Sobo 1909 298.png
| Caption2 = Muscles of the gluteal and posterior femoral regions seen from the front.
| Caption2 = Muscles of the gluteal and posterior femoral regions seen from the front
| Origin = [[Sacrum]]
| Origin = [[Sacrum]]
| Insertion = [[Greater trochanter]]
| Insertion = [[Greater trochanter]]
| Blood = [[Inferior gluteal artery|Inferior gluteal]], [[lateral sacral artery|lateral sacral]] and [[superior gluteal artery]],
| Blood = [[Inferior gluteal artery|Inferior gluteal]], [[lateral sacral artery|lateral sacral]] and [[superior gluteal artery]],
| Nerve = [[Nerve to the piriformis]] ([[Lumbar spinal nerve 5|L5]], [[Sacral spinal nerve 1|S1]], and [[Sacral spinal nerve 2|S2]])
| Nerve = [[Nerve to the piriformis]] ([[Lumbar spinal nerve 5|L5]], [[Sacral spinal nerve 1|S1]], and [[Sacral spinal nerve 2|S2]])
| Action = [[External rotator]] of the [[thigh]]
| Action = [[External rotator]] of the [[thigh]]
}}
}}
The '''piriformis''' ({{ety|la|piriformis|[[pear]]-shaped}}) is a [[muscle]] in the [[buttock|gluteal]] region of the [[lower limbs]]. It is one of the six muscles in the [[lateral rotator group]].
The '''piriformis muscle''' ({{ety|la|piriformis|[[pear|pear-shaped]]}}) is a flat, pyramidally-shaped [[muscle]] in the [[buttock|gluteal]] region of the [[lower limbs]]. It is one of the six muscles in the [[lateral rotator group]].


The piriformis muscle has its origin upon the front surface of the [[sacrum]], and inserts onto the [[greater trochanter]] of the [[femur]]. Depending upon the given position of the leg, it acts either as external (lateral) rotator of the thigh or as abductor of the thigh. It is innervated by the [[piriformis nerve]].
⚫
It was first named by [[Adriaan van den Spiegel]], a professor from the [[University of Padua]] in the 16th century.<ref name="pmid 16311716">{{cite journal |author=Smoll NR |title=Variations of the piriformis and sciatic nerve with clinical consequence: a review |journal=Clinical Anatomy |volume=23 |issue=1 |pages=8–17 |date=January 2010 |pmid=19998490 |doi=10.1002/ca.20893}}</ref>


==Structure==
==Structure==
⚫
[[File:Posterior Hip Muscles 1.PNG|left|thumb|Pelvis seen from behind (the piriformis and the rest of the [[lateral rotator group]] are visible).]]
The piriformis muscle originates from the [[Pelvic surface of sacrum|anterior (front) part]] of the [[sacrum]], the part of the [[Vertebral column|spine]] in the [[gluteal]] region, and from the superior margin of the [[greater sciatic notch]] (as well as the [[sacroiliac joint]] capsule and the [[sacrotuberous ligament]]). It exits the [[pelvis]] through the [[greater sciatic foramen]] to insert on the [[greater trochanter]] of the [[femur]]. Its [[tendon]] often joins with the tendons of the [[superior gemellus]], [[inferior gemellus]], and [[obturator internus]] muscles prior to insertion.
The piriformis is a flat muscle, and is pyramidal in shape.<ref name=":1" />


=== Origin ===
The piriformis is a flat muscle, pyramidal in shape, lying almost parallel with the posterior margin of the [[gluteus medius]].
The piriformis muscle originates from the [[Pelvic surface of sacrum|anterior (front) surface]] of the [[sacrum]]<ref name=":0">{{Citation|last1=Pan|first1=Jason|title=Chapter 24 - Piriformis Syndrome: A Review of the Evidence and Proposed New Criteria for Diagnosis|date=2018-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780323485661000243|work=Challenging Neuropathic Pain Syndromes|pages=205–215|editor-last=Freedman|editor-first=Mitchell K.|publisher=Elsevier|language=en|isbn=978-0-323-48566-1|access-date=2021-02-03|last2=Vasudevan|first2=John|editor2-last=Gehret|editor2-first=Jeffrey A.|editor3-last=Young|editor3-first=George W.|editor4-last=Kamen|editor4-first=Leonard B.}}</ref><ref name=":2">{{Cite book |last=Standring |first=Susan |url=https://www.worldcat.org/oclc/1201341621 |title=Gray's Anatomy: The Anatomical Basis of Clinical Practice |year=2021 |isbn=978-0-7020-7707-4 |edition=42nd |location=[New York] |pages=1244 |oclc=1201341621}}</ref> by three fleshy digitations attached to the [[Sacrum|second, third, and fourth sacral vertebra]].<ref name=":1">{{Citation|last1=Khan|first1=Dost|title=Chapter 67 - Piriformis Syndrome|date=2018-01-01|url=http://www.sciencedirect.com/science/article/pii/B978032340196800067X|work=Essentials of Pain Medicine (Fourth Edition)|pages=613–618.e1|editor-last=Benzon|editor-first=Honorio T.|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-40196-8.00067-x|isbn=978-0-323-40196-8|access-date=2021-02-03|last2=Nelson|first2=Ariana|editor2-last=Raja|editor2-first=Srinivasa N.|editor3-last=Liu|editor3-first=Spencer S.|editor4-last=Fishman|editor4-first=Scott M.}}</ref>


It also arises from the superior margin of the [[greater sciatic notch]],<ref>{{Cite book |last=Hicks |first=Brandon |url=https://www.ncbi.nlm.nih.gov/books/NBK448172/ |title=Piriformis Syndrome |last2=Lam |first2=Jason |last3=Varacallo |first3=Matthew |date=August 4, 2023 |publisher=Treasure Island (FL): StatPearls Publishing |year= |pmid=28846222}}</ref> the gluteal surface of the [[Ilium (bone)|ilium]] (near the [[posterior inferior iliac spine]]), the [[sacroiliac joint]] capsule, and (sometimes) the [[sacrotuberous ligament]] (more specifically, the superior part of the pelvic surface of this ligament).<ref name=":2" />
⚫
It is situated partly within the [[pelvis]] against its posterior wall, and partly at the back of the [[hip-joint]].


=== Insertion ===
It arises from the front of the sacrum by three fleshy digitations, attached to the portions of bone between the first, second, third, and fourth [[anterior sacral foramina]], and to the grooves leading from the foramina: a few fibers also arise from the margin of the [[greater sciatic foramen]], and from the anterior surface of the [[sacrotuberous ligament]].
The muscle inserts onto the [[greater trochanter]] of the [[femur]]<ref name=":0" /> (its [[tendon]] unite with the tendons of the [[superior gemellus]], [[inferior gemellus]], and [[obturator internus]] muscles prior to insertion).<ref name=":3">{{Cite book |last=Chang |first=Carol |url=https://www.ncbi.nlm.nih.gov/books/NBK519497/ |title=Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle |last2=Jeno |first2=Susan H. |last3=Varacallo |first3=Matthew |date=November 13, 2023 |publisher=Treasure Island (FL): StatPearls Publishing |pmid=30137781}}</ref>


=== Innervation ===
The muscle passes out of the pelvis through the [[greater sciatic foramen]], the upper part of which it fills, and is inserted by a rounded tendon into the upper border of the [[greater trochanter]] behind, but often partly blended with, the common tendon of the [[obturator internus]] and [[superior gemellus muscle|superior]] and [[inferior gemellus muscle]]s.
The piriformis muscle is [[Nerve|innervated]] by the [[piriformis nerve]].<ref name=":0" />

=== Relations ===
The posterior aspect of the muscle lies against the sacrum. The anterior surface of the muscle is related to the [[rectum]] (especially on the left side of the body), and the [[sacral plexus]].<ref name=":2" />

⚫
The muscle lies almost parallel with the posterior margin of the [[gluteus medius]]. It is situated partly within the [[pelvis]] against its posterior wall, and partly at the back of the [[hip-joint|hip joint]].<ref name=":3" />

It exits the [[pelvis]] through the [[greater sciatic foramen]]<ref name=":1" /> superior to the sacrospinous ligament.<ref name=":2" />


=== Variation ===
=== Variation ===
In 17% of people, the piriformis muscle is pierced by parts or all of the [[sciatic nerve]]. Several variations occur, but the most common type of anomaly (81% of anomalies) is the Beaton's type B which is when the common peroneal nerve pierces the piriformis muscle.<ref name="pmid 16311716"/>
In around 80% of the population, the [[sciatic nerve]] travels below the piriformis muscle.<ref name=":0" /><ref name=":1" /> In 17% of people, the piriformis muscle is pierced by parts or all of the sciatic nerve.<ref name=":0" /> Several variations occur, one of which is the rarely found Beaton's type-b where the sciatic nerve divides between and below the piriformis.<ref name="Jha">{{cite journal |vauthors=Jha AK, Baral P |title=Composite Anatomical Variations between the Sciatic Nerve and the Piriformis Muscle: A Nepalese Cadaveric Study |journal=Case Rep Neurol Med |volume=2020 |issue= |pages=7165818 |date=2020 |pmid=32292613 |pmc=7150691 |doi=10.1155/2020/7165818 |url= |doi-access=free }}</ref>


It may be united with the [[gluteus medius]], send fibers to the [[gluteus minimus]], or receive fibers from the [[superior gemellus]].
It may be united with the [[gluteus medius]], send fibers to the [[gluteus minimus]], or receive fibers from the [[superior gemellus]].
Line 36: Line 47:


== Function==
== Function==
The piriformis muscle is part of the [[lateral rotators of the hip]], along with the [[quadratus femoris]], [[gemellus inferior]], [[gemellus superior]], [[obturator externus]], and [[obturator internus]]. The piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion. Abduction of the flexed thigh is important in the action of walking because it shifts the body weight to the opposite side of the foot being lifted, which prevents falling. The action of the lateral rotators can be understood by crossing the legs to rest an ankle on the knee of the other leg. This causes the femur to rotate and point the knee laterally. The lateral rotators also oppose medial rotation by the [[gluteus medius]] and [[gluteus minimus]]. When the hip is flexed to 90 degrees, piriformis abducts the femur at the hip and reverses primary function, internally rotating the hip when the hip is flexed at 90 degrees or more. (Netter's Clinical Anatomy, 2010)
The piriformis muscle is part of the [[lateral rotators of the hip]], along with the [[quadratus femoris]], [[gemellus inferior]], [[gemellus superior]], [[obturator externus]], and [[obturator internus]]. The piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion.<ref name=":0" /> Abduction of the flexed thigh is important in the action of walking because it shifts the body weight to the opposite side of the foot being lifted, which prevents falling. The action of the lateral rotators can be understood by crossing the legs to rest an ankle on the knee of the other leg. This causes the femur to rotate and point the knee laterally. The lateral rotators also oppose medial rotation by the [[gluteus medius]] and [[gluteus minimus]]. When the hip is flexed to 90 degrees, piriformis abducts the femur at the hip and reverses primary function, internally rotating the hip when the hip is flexed at 90 degrees or more.<ref>{{Cite book |last=Hansen |first=John T. |url=https://www.worldcat.org/oclc/316421154 |title=Netter's Clinical Anatomy |publisher=Saunders/Elsevier |year=2009 |isbn=978-1-4377-0272-9 |edition=2nd |location=Philadelphia |oclc=316421154}}</ref>


== Clinical significance==
== Clinical significance==

=== Piriformis syndrome ===
{{main|Piriformis syndrome}}
{{main|Piriformis syndrome}}


Piriformis syndrome occurs when the piriformis irritates the [[sciatic nerve]], which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve.<ref name=rice>{{cite web |url=http://www.rice.edu/~jenky/sports/piri.html |title=The piriformis syndrome |access-date=2007-11-16 }}</ref> This referred pain is known as ''[[sciatica]]''. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle. This subgroup of the population is predisposed to developing sciatica.
Piriformis syndrome occurs when the piriformis irritates the [[sciatic nerve]], which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve.<ref name=rice>{{cite web |url=http://www.rice.edu/~jenky/sports/piri.html |title=The piriformis syndrome |access-date=2007-11-16 }}</ref> This referred pain is known as ''[[sciatica]]''. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle. This subgroup of the population is predisposed to developing sciatica.
Sciatica can be described by pain, tingling, or numbness deep in the buttocks and along the sciatic nerve. Sitting down, stretching, climbing stairs, and performing squats usually increases pain. Diagnosing the syndrome is usually based on symptoms and on the physical exam. More testing, including MRIs, X-rays, and nerve conduction tests can be administered to exclude other possible diseases.<ref name=rice/>
Sciatica can be described by pain, tingling, or numbness deep in the buttocks and along the sciatic nerve. Sitting down, stretching, climbing stairs, and performing squats usually increases pain. Diagnosing the syndrome is usually based on symptoms and on the physical exam. More testing, including MRIs, X-rays, and nerve conduction tests can be administered to exclude other possible diseases.<ref name=rice/> If diagnosed with piriformis syndrome, the first treatment involves progressive stretching exercises, massage therapy (including neuromuscular therapy) and physical treatment. Corticosteroids can be injected into the piriformis muscle if pain continues. Findings suggest the possibility that [[Botulinum toxin]] type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.<ref>{{cite journal |author=Lang AM |title=Botulinum toxin type B in piriformis syndrome |journal=American Journal of Physical Medicine & Rehabilitation |volume=83 |issue=3 |pages=198–202 |date=March 2004 |pmid=15043354 |doi=10.1097/01.PHM.0000113404.35647.D8|s2cid=9738513 }}</ref> A more invasive, but sometimes necessary treatment involves surgical exploration; however, the side effects of the surgery could be much worse than alternative treatments such as physical therapy. Surgery should always be a last resort.<ref name=rice/>
If diagnosed with piriformis syndrome, the first treatment involves progressive stretching exercises, massage therapy (including neuromuscular therapy) and physical treatment. Corticosteroids can be injected into the piriformis muscle if pain continues. Findings suggest the possibility that [[Botulinum toxin]] type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.<ref>{{cite journal |author=Lang AM |title=Botulinum toxin type B in piriformis syndrome |journal=American Journal of Physical Medicine & Rehabilitation |volume=83 |issue=3 |pages=198–202 |date=March 2004 |pmid=15043354 |doi=10.1097/01.PHM.0000113404.35647.D8}}</ref>
A more invasive, but sometimes necessary treatment involves surgical exploration; however, the side effects of the surgery could be much worse than alternative treatments such as physical therapy. Surgery should always be a last resort.<ref name=rice/>


===Landmark===
===Landmark===
Line 50: Line 61:


This determines the name of the vessels and nerves in this region – the nerve and vessels that emerge superior to the piriformis are the superior gluteal nerve and superior gluteal vessels. Inferiorly, it is the same, and the sciatic nerve also travels inferiorly to the piriformis.<ref>{{cite web|url=http://teachmeanatomy.info/muscles-of-the-gluteal-region/ |title=Muscles of the Gluteal Region |publisher=TeachMeAnatomy |access-date=2012-12-15}}</ref>
This determines the name of the vessels and nerves in this region – the nerve and vessels that emerge superior to the piriformis are the superior gluteal nerve and superior gluteal vessels. Inferiorly, it is the same, and the sciatic nerve also travels inferiorly to the piriformis.<ref>{{cite web|url=http://teachmeanatomy.info/muscles-of-the-gluteal-region/ |title=Muscles of the Gluteal Region |publisher=TeachMeAnatomy |access-date=2012-12-15}}</ref>

== History ==
⚫
The piriformis muscle was first named by [[Adriaan van den Spiegel]], a professor from the [[University of Padua]] in the 16th century.<ref name="pmid 16311716">{{cite journal|author=Smoll NR|date=January 2010|title=Variations of the piriformis and sciatic nerve with clinical consequence: a review|journal=Clinical Anatomy|volume=23|issue=1|pages=8–17|doi=10.1002/ca.20893|pmid=19998490|s2cid=23677435}}</ref>


== Additional images ==
== Additional images ==
{{Cleanup gallery anatomy}}
<gallery>
<gallery>
⚫
File:Posterior Hip Muscles 1.PNG|Pelvis seen from behind (the piriformis and the rest of the [[lateral rotator group]] are visible)
File:Piriformis muscle.PNG|Muscles of the gluteal and posterior femoral regions
File:Piriformis muscle.PNG|Muscles of the gluteal and posterior femoral regions
File:Sobo 1909 296.png
File:Sobo 1909 296.png
File:Sobo 1909 297.png
File:Sobo 1909 300.png
File:Sobo 1909 300.png
File:Sobo 1909 301.png
File:Sobo 1909 302.png
File:Slide2ERVA.JPG|Pelvic contents: male.Superior view.Deep dissection.
</gallery>
</gallery>

== See also ==

* [[Piriformis syndrome]]
* [[Deep gluteal syndrome]]
* [[Lateral rotators of the hip]]
* [[Piriformis nerve]]
* [[Greater sciatic foramen]]
* [[Sacrum]]
* [[Greater trochanter]]


== References ==
== References ==

Latest revision as of 19:27, 4 August 2024

Piriformis muscle
Buttocks seen from behind (the piriformis and the rest of the lateral rotator group are visible)
Muscles of the gluteal and posterior femoral regions seen from the front
Details
OriginSacrum
InsertionGreater trochanter
ArteryInferior gluteal, lateral sacral and superior gluteal artery,
NerveNerve to the piriformis (L5, S1, and S2)
ActionsExternal rotator of the thigh
Identifiers
Latinmusculus piriformis
TA98A04.7.02.011
TA22604
FMA19082
Anatomical terms of muscle

The piriformis muscle (from Latin piriformis 'pear-shaped') is a flat, pyramidally-shaped muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group.

The piriformis muscle has its origin upon the front surface of the sacrum, and inserts onto the greater trochanter of the femur. Depending upon the given position of the leg, it acts either as external (lateral) rotator of the thigh or as abductor of the thigh. It is innervated by the piriformis nerve.

Structure

[edit]
Pelvis seen from behind (the piriformis and the rest of the lateral rotator group are visible).

The piriformis is a flat muscle, and is pyramidal in shape.[1]

Origin

[edit]

The piriformis muscle originates from the anterior (front) surface of the sacrum[2][3] by three fleshy digitations attached to the second, third, and fourth sacral vertebra.[1]

It also arises from the superior margin of the greater sciatic notch,[4] the gluteal surface of the ilium (near the posterior inferior iliac spine), the sacroiliac joint capsule, and (sometimes) the sacrotuberous ligament (more specifically, the superior part of the pelvic surface of this ligament).[3]

Insertion

[edit]

The muscle inserts onto the greater trochanter of the femur[2] (its tendon unite with the tendons of the superior gemellus, inferior gemellus, and obturator internus muscles prior to insertion).[5]

Innervation

[edit]

The piriformis muscle is innervated by the piriformis nerve.[2]

Relations

[edit]

The posterior aspect of the muscle lies against the sacrum. The anterior surface of the muscle is related to the rectum (especially on the left side of the body), and the sacral plexus.[3]

The muscle lies almost parallel with the posterior margin of the gluteus medius. It is situated partly within the pelvis against its posterior wall, and partly at the back of the hip joint.[5]

It exits the pelvis through the greater sciatic foramen[1] superior to the sacrospinous ligament.[3]

Variation

[edit]

In around 80% of the population, the sciatic nerve travels below the piriformis muscle.[2][1] In 17% of people, the piriformis muscle is pierced by parts or all of the sciatic nerve.[2] Several variations occur, one of which is the rarely found Beaton's type-b where the sciatic nerve divides between and below the piriformis.[6]

It may be united with the gluteus medius, send fibers to the gluteus minimus, or receive fibers from the superior gemellus.

It may have one or two sacral attachments; or it may be inserted into the capsule of the hip joint.

Function

[edit]

The piriformis muscle is part of the lateral rotators of the hip, along with the quadratus femoris, gemellus inferior, gemellus superior, obturator externus, and obturator internus. The piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion.[2] Abduction of the flexed thigh is important in the action of walking because it shifts the body weight to the opposite side of the foot being lifted, which prevents falling. The action of the lateral rotators can be understood by crossing the legs to rest an ankle on the knee of the other leg. This causes the femur to rotate and point the knee laterally. The lateral rotators also oppose medial rotation by the gluteus medius and gluteus minimus. When the hip is flexed to 90 degrees, piriformis abducts the femur at the hip and reverses primary function, internally rotating the hip when the hip is flexed at 90 degrees or more.[7]

Clinical significance

[edit]

Piriformis syndrome

[edit]
Main article: Piriformis syndrome

Piriformis syndrome occurs when the piriformis irritates the sciatic nerve, which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve.[8] This referred pain is known as sciatica. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle. This subgroup of the population is predisposed to developing sciatica. Sciatica can be described by pain, tingling, or numbness deep in the buttocks and along the sciatic nerve. Sitting down, stretching, climbing stairs, and performing squats usually increases pain. Diagnosing the syndrome is usually based on symptoms and on the physical exam. More testing, including MRIs, X-rays, and nerve conduction tests can be administered to exclude other possible diseases.[8] If diagnosed with piriformis syndrome, the first treatment involves progressive stretching exercises, massage therapy (including neuromuscular therapy) and physical treatment. Corticosteroids can be injected into the piriformis muscle if pain continues. Findings suggest the possibility that Botulinum toxin type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.[9] A more invasive, but sometimes necessary treatment involves surgical exploration; however, the side effects of the surgery could be much worse than alternative treatments such as physical therapy. Surgery should always be a last resort.[8]

Landmark

[edit]

The piriformis is a very important landmark in the gluteal region. As it travels through the greater sciatic foramen, it effectively divides it into an inferior and superior part.

This determines the name of the vessels and nerves in this region – the nerve and vessels that emerge superior to the piriformis are the superior gluteal nerve and superior gluteal vessels. Inferiorly, it is the same, and the sciatic nerve also travels inferiorly to the piriformis.[10]

History

[edit]

The piriformis muscle was first named by Adriaan van den Spiegel, a professor from the University of Padua in the 16th century.[11]

Additional images

[edit]
  • Muscles of the gluteal and posterior femoral regions
    Muscles of the gluteal and posterior femoral regions

See also

[edit]

References

[edit]

Public domain This article incorporates text in the public domain from page 476 of the 20th edition of Gray's Anatomy (1918)

  1. ^ a b c d Khan, Dost; Nelson, Ariana (2018-01-01), Benzon, Honorio T.; Raja, Srinivasa N.; Liu, Spencer S.; Fishman, Scott M. (eds.), "Chapter 67 - Piriformis Syndrome", Essentials of Pain Medicine (Fourth Edition), Elsevier, pp. 613–618.e1, doi:10.1016/b978-0-323-40196-8.00067-x, ISBN 978-0-323-40196-8, retrieved 2021-02-03
  2. ^ a b c d e f Pan, Jason; Vasudevan, John (2018-01-01), Freedman, Mitchell K.; Gehret, Jeffrey A.; Young, George W.; Kamen, Leonard B. (eds.), "Chapter 24 - Piriformis Syndrome: A Review of the Evidence and Proposed New Criteria for Diagnosis", Challenging Neuropathic Pain Syndromes, Elsevier, pp. 205–215, ISBN 978-0-323-48566-1, retrieved 2021-02-03
  3. ^ a b c d Standring, Susan (2021). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). [New York]. p. 1244. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  4. ^ Hicks, Brandon; Lam, Jason; Varacallo, Matthew (August 4, 2023). Piriformis Syndrome. Treasure Island (FL): StatPearls Publishing. PMID 28846222.
  5. ^ a b Chang, Carol; Jeno, Susan H.; Varacallo, Matthew (November 13, 2023). Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle. Treasure Island (FL): StatPearls Publishing. PMID 30137781.
  6. ^ Jha AK, Baral P (2020). "Composite Anatomical Variations between the Sciatic Nerve and the Piriformis Muscle: A Nepalese Cadaveric Study". Case Rep Neurol Med. 2020: 7165818. doi:10.1155/2020/7165818. PMC 7150691. PMID 32292613.
  7. ^ Hansen, John T. (2009). Netter's Clinical Anatomy (2nd ed.). Philadelphia: Saunders/Elsevier. ISBN 978-1-4377-0272-9. OCLC 316421154.
  8. ^ a b c "The piriformis syndrome". Retrieved 2007-11-16.
  9. ^ Lang AM (March 2004). "Botulinum toxin type B in piriformis syndrome". American Journal of Physical Medicine & Rehabilitation. 83 (3): 198–202. doi:10.1097/01.PHM.0000113404.35647.D8. PMID 15043354. S2CID 9738513.
  10. ^ "Muscles of the Gluteal Region". TeachMeAnatomy. Retrieved 2012-12-15.
  11. ^ Smoll NR (January 2010). "Variations of the piriformis and sciatic nerve with clinical consequence: a review". Clinical Anatomy. 23 (1): 8–17. doi:10.1002/ca.20893. PMID 19998490. S2CID 23677435.
[edit]
Retrieved from "https://en.wikipedia.org/w/index.php?title=Piriformis_muscle&oldid=1238609129"