Ewha Med J.  2024 Apr;47(2):e30. 10.12771/emj.2024.e30.

Ultrasound-guided sciatic nerve block in a patient with sciatic neuropathy associated with uterine myoma: a case report

• Kang BK
• Beak MH
• Kim Wj

• KMID: 2556319
• DOI: http://doi.org/10.12771/emj.2024.e30

Abstract

Although sciatica is commonly associated with lumbar spinal issues, it is important to acknowledge that non-spinal factors can also play a significant role in this condition. This is particularly relevant for female patients, in whom gynecologic conditions can lead to secondary sciatic neuropathy. Herein, we report the case of a 66-year-old woman who experienced posterolateral right lower extremity radiating pain. We initially performed a lumbar transforaminal epidural steroid injection, but the pain persisted. Subsequently, hip MRI revealed sciatic neuropathy adjacent to the pedunculated portions of a uterine myoma. We then performed a sub-gluteal sciatic nerve block under ultrasound guidance, resulting in significant relief of her pain. In conclusion, hip MRI can be helpful for the differential diagnosis of sciatica, and ultrasound-guided sciatic nerve block can be considered an appropriate and effective treatment option.

Keyword

Diagnosis, differential; Ultrasonography, interventional; Magnetic resonance imaging; Myoma; Sciatica

Figure

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  Fig. 1. Lumbar MRI. (A) Sagittal view, (B) axial view.

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  Fig. 2. Hip MRI. (A) Coronal view, (B) axial view. Arrows: sciatic nerve.

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  Fig. 3. Ultrasound-guided sub-gluteal sciatic nerve block. Arrowhead: needle trajectory. IT, ischial tuberosity; GT, greater trochanter.

Reference

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