Myofascial Trigger Points in the Ipsilateral Gluteal Muscles Associated with Pyogenic Sacroiliitis: A Case Report

Abstract

Background: Pyogenic sacroiliitis is a relatively rare condition and the clinical manifestations may mimic more common diseases of the hip, lumbar spine and abdomen. It may also activate myofascial trigger points [MTrPs] in the gluteal and piriformis muscles but this has never been reported.

Findings: A patient who suffered from pyogenic sacroiliitis with prominent MTrPs in the ipsilateral gluteal and piriformis muscles is presented. The clinical symptoms and signs mimic herniated intervertebral disc. After the MTrP injection therapy, this patient had obtained total pain relief and immediate restoration of the ambulation function. Antibiotics were administered to treat the underlying pyogenic sacroiliitis for long-term remission and all active MTrPs were inactivated during the period of remission.

Conclusions: Myofascial trigger points in the gluteal and piriformis muscles may be activated by sacroiliitis. Any patient who had previous history of fever, increased erythrocyte sedimentation rate and complains of radiating pain to the lower leg and active MTrPs in the gluteal and piriformis muscles should be examined for possible sacroiliitis.

KEYWORDS:

• Myofascial trigger point
• herniated intervertebral disc
• pyogenic sacroiliitis