Piriformis Test

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Original Editor - Anquain Sullivan, Frederik Topke

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Search Strategy

Database: Pubmed
Keywords: Piriformis test, FAIR test, piriformis syndrome

Database: Web of Knowledge
Keywords: Piriformis test, FAIR test

Definition/Description

The Piriformis test is a lower limb provocation test to evaluate the impact of the piriformis muscle on the sciatic nerve. 

Clinically Relevant Anatomy

M.Piriformis is a flat muscle and is one of the deep lateral hip rotators. The origin is on the facies pelvina (anterior side) of the Os sacrum and has a insertion at the superior aspect of the trochanter major of the femur. The piriformis muscle is running over the top of the sciatic nerve. This muscle has the function of external rotation, abduction and extension in the hip and it is also important to stabilize the joint of the hip. And is innervate by the direct branches from the sacral plexus (L5-S2). 

Sciatic nerve or also named as N. Ishiadicus ,passes behind the hip joint to the muscles lying underneath. Above the knee joint, the sciatic nerve splits into two branches: N. Tibialis and the N. Fibularis communis. The sciatic nerve passes over or under the piriformis muscle but it is also possible that the sciatic nerve passes, partially or whole, trough the piriformis muscle. This depends from person to person.

Purpose

The piriformis test is used to screen the piriformis muscle and to detect tightness or other discomforts of the sciatic nerve as it passes trought or under the Piriformis muscle. Because this is a muscle and neurological test.<9>

Technique

 

With the patient in side-lying with the involved side up the patient's involved leg is passively flexed, adducted, and internally rotated.

Positive test is when the patient reports pain reproduced at the region of the piriformis.

Key Research

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A study was performed by Fishman et al. that determine the sensitivity and specificity of the piriformis test.

Sensitivity = .88²     -LR = .14

Specificity = .83²    +LR = 5.2

Resources

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Clinical Bottom Line

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Recent Related Research (from Pubmed)

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References

1. Flynn, T, Cleland, J, Whitman, J. Users' Guide to the Musculoskeletal Examination. (2008) pg 238
2. Fishman, L, Dombi, G, Michaelson, C, Ringel, S. Piriformis syndrome: Diagnosis, treatment and outcome- a 10 year study. Arch Phys Med Rehabil 2002; 83:295-301.
3. Fishman, L, Zybert, P. Electrophysiologic evidence of piriformis syndrome. Arch Phys Med Rehabil 1992; 73:359-364.