viernes, 16 de diciembre de 2016

Síndrome glúteo / Gluteal syndrome



Diciembre 13,  2016. No. 2537






Síndrome glúteo profundo
Deep gluteal syndrome.
J Hip Preserv Surg. 2015 Jul;2(2):99-107. doi: 10.1093/jhps/hnv029. Epub 2015 Jun 6.
Abstract
Deep gluteal syndrome describes the presence of pain in the buttock caused from non-discogenic and extrapelvic entrapment of the sciatic nerve. Several structures can be involved in sciatic nerve entrapment within the gluteal space. A comprehensive history and physical examination can orientate the specific site where the sciatic nerve is entrapped, as well as several radiological signs that support the suspected diagnosis. Failure to identify the cause of pain in a timely manner can increase pain perception, and affect mental control, patient hope and consequently quality of life. This review presents a comprehensive approach to the patient with deep gluteal syndrome in order to improve the understanding of posterior hip anatomy, nerve kinematics, clinical manifestations, imaging findings, differential diagnosis and treatment considerations.
Síndrome glúteo profundo: anatomía, imagen y tratamiento del atrapamiento de nervio ciático en el espacio subgluteo
Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space.
Skeletal Radiol. 2015 Jul;44(7):919-34. doi: 10.1007/s00256-015-2124-6. Epub 2015 Mar 5.
Abstract
Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome," a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal spaceanatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation
Actualización en el síndrome del glúteo medio
P. Martínez Rodríguez a, D. Calvo Rodríguez , A. González Cal, G. Calvo Mosquera
Resumen
El dolor de espalda y/o región glútea es un motivo de consulta frecuente en atención primaria y en muchas ocasiones resulta difícil precisar su origen. Cuando un paciente consulta por este motivo solemos dirigir el foco de atención hacia el estudio de las estructuras óseas y nerviosas, sin tener en cuenta que en un gran número de casos está implicado el sistema miofascial. En un estudio realizado en 250 pacientes con el objetivo de determinar la prevalencia de tendinosis y roturas del glúteo medio o menor, se comprobó por medio de RM que el 14% de los pacientes que acudían al médico por dolor en la nalga, cadera o ingle presentaban este tipo de lesión en alguno de los músculos mencionados. En estos casos un diagnóstico y tratamiento precoz con infiltraciones es fundamental para evitar la progresión a un dolor persistente y disminución de la función muscular.
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015
Publicar un comentario