AOHC Encore 2022-313: Pain in the Butt: A Comprehensive Evaluation

Video Transcription

Video Summary

In this video, Dr. Yusuf Saeed, an assistant professor at the Uniformed Services University, discusses various pathologies of the posterior thigh, primarily focusing on hip and lumbar spine issues. He explains that pain in the posterior thigh can be caused by problems in the hip joint, such as facet joint arthropathy, spondyloarthropathy, and degenerative disc disease. Dr. Saeed discusses the anatomy of the facet joints and their role in creating pain in the posterior thigh. He also explains how medial branch nerves supply the facet joints and how medial branch blocks are used to diagnose facet joint arthropathy. He emphasizes the importance of accurate diagnosis before proceeding with interventions such as radiofrequency ablation. Dr. Saeed also discusses the role of discs in causing posterior thigh pain, particularly in cases of degenerative disc disease and herniation. He explains the referral patterns and diagnostic tests used to identify disc-related pain. He then moves on to discuss piriformis syndrome, which can cause pain in the buttocks and posterior thigh. He explains the anatomy of the piriformis muscle and the sciatic nerve, and how compression of the sciatic nerve by the piriformis muscle can cause referred pain. Dr. Saeed describes the examination maneuvers used to diagnose piriformis syndrome and the ultrasound-guided injection techniques used to treat it. Finally, he briefly mentions ischial bursitis as another possible cause of posterior thigh pain.

Keywords

posterior thigh

hip joint

facet joint arthropathy

degenerative disc disease

anatomy

medial branch nerves

radiofrequency ablation

herniation

piriformis syndrome

sciatic nerve

ischial bursitis