A Case Report: Calcific Piriformis Tendinitis in a Patient with Known Sarcoidosis
Journal Title: Journal of Orthopaedic Science and Research - Year 2023, Vol 4, Issue 3
Abstract
Calcific tendinitis most commonly involves the rotator cuff tendons. The tendons around the hip are the second most common location for calcific tendinitis to occur. Symptomatic calcific piriformis tendinitis, without calcific tendinitis elsewhere, is an extremely rare diagnosis. This case report describes calcific piriformis tendinitis diagnosed on Magnetic Resonance Imaging (MRI) in a 42-year-old man whom presented with a 7-day history of left non-specific hip pain. His past medically history included sarcoidosis and a previous gluteal abscess treated with antibiotics. He has been in remission from sarcoidosis for a decade. MRI demonstrated linear uniform low signal on all sequences involving the intramuscular tendon of piriformis with marked inflammatory change within the surrounding muscle, consistent with acute calcific piriformis tendinitis. Given the results of the MRI, the patient was treated with oral high-dose non-steroidal anti-inflammatory medication (naproxen) as per the first line recommended treatment of calcific tendinitis. Patient remained symptom free and returned to normal activities of daily living and continued to exercise. To date there has been no recurrence. Calcific tendinitis of the piriformis is scarce in medical literature with a recent review finding only two available cases reported. Given the history of sarcoidosis granulomatous myositis was the major differential diagnosis, both clinically and on imaging. However, this condition usually has variable signal intensity within the granulomas and is associated with epimuscular fasciitis. The imaging findings suggest calcification and the full recovery of symptoms post treatment for calcific piriformis tendinitis support the use of diagnosis via imaging.
Authors and Affiliations
Katherine Marino, Justin Lee, Elena Nikiphorou, Ajai Seth
Keywords
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- EP ID EP724140
- DOI https://doi.org/10.46889/JOSR.2023.4306
- Views 27
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