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Sciatica caused by pyomyositis of the piriformis muscle in a pediatric patient.
[pyomyositis]
Because
the
sciatic
nerve
leaves
the
pelvis
through
the
greater
sciatic
notch
underneath
the
piriformis
muscle
,
any
pathology
of
the
piriformis
muscle
could
result
in
entrapment
of
the
sciatic
nerve
;
this
is
widely
known
as
piriformis
muscle
syndrome
.
Pyomyositis
of
the
piriformis
muscle
may
be
a
cause
of
piriformis
muscle
syndrome
.
Piriformis
muscle
syndrome
caused
by
pyomyositis
of
the
piriformis
muscle
in
pediatric
patients
is
rare
.
This
article
describes
a
case
of
sciatica
caused
by
pyomyositis
of
the
piriformis
muscle
in
a
pediatric
patient
.
A
6
-
year
-old
boy
presented
with
right
buttock
and
thigh
pain
following
a
mild
fever
and
sore
throat
.
The
pain
worsened
,
and
he
became
unable
to
walk
.
On
admission
,
his
temperature
was
38
.
4
°
C
.
He
reported
severe
right
-sided
buttock
and
lateral
thigh
pain
.
Positive
Freiberg
sign
was
observed
.
Laboratory
examination
revealed
elevated
white
blood
cell
count
and
C-
reactive
protein
level
.
T
2
-
weighted
magnetic
resonance
images
of
the
pelvis
revealed
high
-intensity
changes
of
the
piriformis
muscle
and
iliosacral
joint
.
Thus
,
piriformis
syndrome
caused
by
pyomyositis
of
the
piriformis
muscle
was
diagnosed
.
Oral
antibiotics
(
10
mg
/
kg
per
day
of
cefdinir
)
were
administered
.
Pain
gradually
decreased
,
and
the
patient
was
able
to
walk
.
Final
follow-up
examination
at
6
months
after
symptom
onset
revealed
no
sciatic
pain
.
Follow-up
magnetic
resonance
imaging
revealed
normalized
intensities
of
the
piriformis
muscle
.
The
endopelvic
fascia
provides
a
route
for
infection
from
the
pelvis
to
the
piriformis
.
The
pyomyositis
of
the
piriformis
muscle
in
the
current
case
may
have
occurred
secondary
to
the
pyoarthritis
of
the
sacroiliac
joint
.
Endopelvic
infections
involving
the
piriformis
muscle
may
mimic
hip
diseases
in
pediatric
patients
.