Hip: piriformis syndrome: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Hip: piriformis syndrome

Sample item

A cyclist has deep buttock pain radiating down the back of the thigh, worse on prolonged sitting and with resisted external rotation of the flexed hip. The lumbar MRI is normal. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Piriformis syndrome with sciatic nerve irritation

Piriformis syndrome is irritation of the sciatic nerve as it passes beneath or through the piriformis muscle, producing buttock pain with sciatica-like symptoms. Pain is reproduced by sitting, and by resisted abduction and external rotation of the hip. Treatment is stretching and physiotherapy, and injection for refractory cases.

Option by option

  • A. Meralgia paraesthetica

    Meralgia paraesthetica causes lateral thigh numbness without motor symptoms.

  • B. Piriformis syndrome with sciatic nerve irritation (correct)

    Correct. Buttock pain with sciatic radiation and a normal spine MRI suggests piriformis syndrome.

  • C. Greater trochanteric bursitis

    Trochanteric bursitis causes lateral hip tenderness and not radiating posterior pain.

  • D. L5 disc prolapse

    A disc prolapse would show on MRI and cause dermatomal symptoms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Piriformis syndrome with sciatic nerve irritation. Piriformis syndrome is irritation of the sciatic nerve as it passes beneath or through the piriformis muscle, producing buttock pain with sciatica-like symptoms.

Why is "Meralgia paraesthetica" not the answer?

Meralgia paraesthetica causes lateral thigh numbness without motor symptoms.

Why is "Greater trochanteric bursitis" not the answer?

Trochanteric bursitis causes lateral hip tenderness and not radiating posterior pain.

Why is "L5 disc prolapse" not the answer?

A disc prolapse would show on MRI and cause dermatomal symptoms.

What concept does this question test?

It tests Hip: piriformis syndrome in Orthopaedics. Pain is reproduced by sitting, and by resisted abduction and external rotation of the hip. Treatment is stretching and physiotherapy, and injection for refractory cases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hip: piriformis syndrome?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.