Symptomatic piriformis muscle asymmetry
Sciatica-like pain radiating down the back of the left thigh, worse when sitting. No explanatory causes on lumbar spinal MRI.
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The left piriformis muscle is more prominent than the right, especially at its lower border, where there seems to be an additional fascicle exiting through the sciatic notch.
Piriformis syndrome is an ill-defined condition relating to entrapment of the sciatic nerve caused by hypertrophy, swelling, spasm or accessory muscle bellies of the piriformis within the sciatic notch. It is primarily a diagnosis of exclusion. MRI may help to show the aforementioned changes.