injuries poisoning
Piriformis Syndrome
Diagnosis of Piriformis Syndrome
Physical examination and provocative testing Diagnosis is by physical examination. Pain with forceful internal rotation of the flexed thigh (Freiberg maneuver), abduction of the affected leg while sitting (Pace maneuver), raising of the knee several centimeters off the table while lying on a table on the side of the unaffected leg (Beatty maneuver), or pressure into the buttocks where the sciatic nerve crosses the piriformis muscle while the patient slowly bends to the floor (Mirkin test) is diagnostic. Imaging is not useful except to rule out other causes of sciatic compression. Lumbar disk compression of the sciatic nerve ( Sciatica ) also can result in radiation of pain down the lower extremity below the knee and often is associated with back pain. However, differentiation from a lumbar disk disorder can be difficult, and referral to a specialist may be needed. 