2-Piriformis Syndrome: A Case Study

The three diagnoses:
1- Piriformis Syndrome
2- Mysofascial pain syndrome (trigger points in para-spinal muscles).
3- Deep Pain Thrombosis (DVT)

List the three diagnoses with evidence:
1- Deep Pain Thrombosis (DVT)
The physical examination showed a positive Homans 's sign, where this test is often used to diagnose the DVT (Levi, Hart, & Buller, 1999). Moreover, the signs as warmth, shiny skin of the left leg, edema of the left thigh which extends to lateral side of calf, and the pressure palpations are related to DVT. It is not recommended to ask the patient to be on bed as the previous practice was advising. However, ask the patient to walk normally, where ambulation does not lead to pulmonary embolism as was thought in the past (Anderson, Overend, Godwin, Sealy, & Sunderji, 2009).

2-

The patient mostly comes with pain at the sacrum region and radiates to the extension sciatic nerve. More symptoms can occur as: pain aggravates with activity, abnormal gain (antalegic gate), numbness of the leg, and pain if rising from squatting. The Piriformis muscle spasm may appears as a palpable mass in the buttock area (Chaitow L, 1998).
The Prifiormis syndrome can lead to some complications as the swelling and the DVT due to the entrapment of the nerves and blood vessels (Bustamante & Houlton, 2001). The ROM of the hip showed normal muscle joint integrity where there was no limited movement due to Piriformis spam. Thus, this may lead to exclude the Piriformis syndrome.
3- Myofascial pain can referred the pain to the leg especially the trigger point which locates in gluteus Minimus muscle. This trigger point can give symptoms that mimic the sciatica. However, this diagnosis can be excluded to some extent where the case has swelling in the