Ultrasound-Guided Piriformis Injection: Technique Description and Verification

Smith J, Hurdle M-F, Locketz AJ, Wisniewski SJ. Ultrasound-guided piriformis injection: technique description and verification. Piriformis injections are commonly used in the evaluation and treatment of patients presenting with buttock pain syndromes. Because of its small size, deep location, and relation to adjacent neurovascular structures, the piriformis is traditionally injected by using electromyographic, fluoroscopic, computed tomographic, or magnetic resonance imaging guidance. This report describes and verifies a technique for performing ultrasound-guided piriformis injections. Ultrasound offers several advantages over traditional imaging approaches, including accessibility, compact size, lack of ionizing radiation exposure, and direct visualization of neurovascular structures. With appropriate training and experience, interested physiatrists can consider implementing ultrasound-guided piriformis injections into their clinical practices.