Presentation
Bilateral hip pain and bilateral sciatica, which relatively decreased when walking.
Patient Data
Bilateral gluteal varicose veins are noted, causing a mass effect on the bilateral sciatic nerves. These changes are more prominent on the left side.
There is a narrowing of the bilateral hips joint spaces, with subchondral cystic changes of the left acetabulum, representing osteoarthritis.
Normal hip joint alignment. No signs of avascular necrosis. No bone marrow edema. No femoroacetabular impingement. No ischiofemoral impingement. No hip dysplasia. No significant joint effusion. No labral/paralabral cysts.
Case Discussion
Gluteal varicosities are a rare cause of sciatica, which typically worsens by lying supine or sitting 1 and improves by walking; the latter likely due to venous collapse 2.
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