Open AccessUltrasound-Guided Quadratus Femoris Muscle Injection in Patients with Lower Buttock Pain: Novel Ultrasound-Guided Approach and Clinical Effectiveness
Author(s) -
Do-Hyeong Kim,
Duck Mi Yoon,
Kyung Bong Yoon
Publication year - 2016
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj/2016.19.e863
Subject(s) - medicine , ultrasound , lidocaine , retrospective cohort study , ischial tuberosity , sciatica , thigh , surgery , anesthesia , radiology
Background: The quadratus femoris (QF) muscle is a possible source of lower buttock pain asevidenced by what is known about the pathophysiology of ischiofemoral impingement syndrome.However, there are few reports about the interventional management of the QF muscle as a paingenerator.Objective: To describe an ultrasound-guided QF muscle injection technique in patients withlower buttock pain suspected of QF muscle pathology and to report the result of treatment.Study Design: Retrospective evaluation.Setting: Outpatient department for interventional pain management at a university hospital.Methods: We studied 14 patients who had deep tenderness localized to the lower buttockregion at a point halfway between the lateral prominence of the greater trochanter and the ischialtuberosity corresponding to the location of the QF muscle belly. Under ultrasound guidance, 8 mLof 0.25% lidocaine was injected into the QF muscle. Pain scores were assessed prior to the firstinjection and 2 weeks after the last injection. Patient satisfaction was also assessed.Results: When compared before and 2 weeks after last QF muscle injection, the mean painscore decreased by 49.3% (6.7 ± 2.3 to 3.4 ± 2.1, P < 0.001). Two weeks after the last injection,approximately 70% of patients (10 of 14 patients) expressed their satisfaction as excellent or goodand the average frequency of injection was 2.5 times. There were no complications observed.Limitations: The results of this study should be considered preliminary owing to the smallsample size and lack of a control group, and the retrospective characteristics of this study mayhave introduced a selection bias.Conclusions: Ultrasound-guided QF muscle injection with local anesthetic helps alleviate pain inpatients with lower buttock pain attributed to the QF muscle, and leads to high levels of satisfactionfor patients. A randomized placebo-controlled trial should be considered in the future.Key words: Buttocks, injections, intramuscular, myofascial pain syndromes, quadratus femoris,ultrasonography