Abstract
Pelvic and intrapelvic infections may involve various anatomic structures including bones, joints, muscles, intrapelvic organs, vessels, and nerves (Table 89.1). Sometimes, these infectious lesions may cause sciatic pain, which is difficult to distinguish from traditional spinal sciatica. However, most patients with sciatica related to pelvic and intrapelvic infections present with a lumbosacral plexus neuropathy much more than an “isolated” L5/S1 radiculopathy or a “pure” sciatic peripheral mononeuropathy. In addition, further signs and symptoms of local and/or general infection are highly suggestive but may be lacking.
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Further Reading
Abbas TO. Pelvic primary staphylococcal infection presenting as a thigh abscess. Case Rep Surg. 2013;2013:539737. https://doi.org/10.1155/2013/539737.
Aguilera V, Calvo F, Nos P, Molla A, Esteban R, Ponce J. Sciatica secondary to a presacral abscess as the first manifestation of Crohn’s disease. Gastroenterol Hepatol. 2002;25:505–7. https://doi.org/10.1016/s0210-5705(02)70301-4.
Akhaddar A, Hall W, Ramraoui M, Nabil M, Elkhader A. Primary tuberculous psoas abscess as a postpartum complication: case report and literature review. Surg Neurol Int. 2018;9:239. https://doi.org/10.4103/sni.sni_329_18.
Amato L, Valeri M, Emini P, Ciaccarini R, Petrina A, Ribacchi F, et al. Retroperitoneal and iliopsoas abscess as Crohn’s disease onset mimicking a common lumbosciatic pain. Ann Ital Chir. 2022;11:S2239253X22037458.
Andrews DW, Friedman NB, Heier L, Erickson A, Lavyne MH. Tuboovarian abscess presenting as sciatic pain: case report. Neurosurgery. 1987;21:100–3. https://doi.org/10.1227/00006123-198707000-00024.
Baba H, Okumura Y, Furusawa N, Omori H, Kawahara H, Fujita T, et al. Dumb-bell shaped tuberculous abscess across the greater sciatic notch compressing both sciatic nerves. Spinal Cord. 1998;36:584–7. https://doi.org/10.1038/sj.sc.3100550.
Casola G, vanSonnenberg E, D’Agostino HB, Harker CP, Varney RR, Smith D. Percutaneous drainage of tubo-ovarian abscesses. Radiology. 1992;182:399–402. https://doi.org/10.1148/radiology.182.2.1732956.
Chen WS. Chronic sciatica caused by tuberculous sacroiliitis. A case report. Spine (Phila Pa 1976). 1995;20:1194–6. https://doi.org/10.1097/00007632-199505150-00015.
Cohen BA, Lanzieri CF, Mendelson DS, Sacher M, Hermann G, Train JS, Rabinowitz JG. CT evaluation of the greater sciatic foramen in patients with sciatica. AJNR Am J Neuroradiol. 1986;7:337–42.
Colmegna I, Justiniano M, Espinoza LR, Gimenez CR. Piriformis pyomyositis with sciatica: an unrecognized complication of “unsafe” abortions. J Clin Rheumatol. 2007;13:87–8. https://doi.org/10.1097/01.rhu.0000260655.90449.7d.
García-Mata S, Hidalgo-Ovejero A, Esparza-Estaun J. Primary obturator-muscle pyomyositis in immunocompetent children. J Child Orthop. 2012;6:205–15. https://doi.org/10.1007/s11832-012-0418-y.
Granberg S, Gjelland K, Ekerhovd E. The management of pelvic abscess. Best Pract Res Clin Obstet Gynaecol. 2009;23:667–78. https://doi.org/10.1016/j.bpobgyn.2009.01.010.
Gujrathi R, Gupta K, Ravi C, Pai B. Sciatica: an extremely rare complication of the perianal abscess. Pol J Radiol. 2016;81:370–3. https://doi.org/10.12659/PJR.897269.
Gupta A, Kakkar A, Chadha M, Sathaye CB. A primary intrapelvic hydatid cyst presenting with foot drop and a gluteal swelling: a case report. J Bone Joint Surg Br. 1998;80:1037–9. https://doi.org/10.1302/0301-620x.80b6.8793.
Gurbani SG, Cho CT, Lee KR, Powell L. Gonococcal abscess of the obturator internal muscle: use of new diagnostic tools may eliminate the need for surgical intervention. Clin Infect Dis. 1995;20:1384–6. https://doi.org/10.1093/clinids/20.5.1384.
Harisinghani MG, Gervais DA, Hahn PF, Cho CH, Jhaveri K, Varghese J, et al. CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and clinical outcome. Radiographics. 2002;22:1353–67. https://doi.org/10.1148/rg.226025039.
Hassan FO, Shannak A. Primary pelvic hydatid cyst: an unusual cause of sciatica and foot drop. Spine (Phila Pa 1976). 2001;26:230–2. https://doi.org/10.1097/00007632-200101150-00021.
Herr CH, Williams JC. Supralevator anorectal abscess presenting as acute low back pain and sciatica. Ann Emerg Med. 1994;23:132–5. https://doi.org/10.1016/s0196-0644(94)70020-6.
Holtzman DM, Davis RE, Greco CM. Lumbosacral plexopathy secondary to perirectal abscess in a patient with HIV infection. Neurology. 1989;39:1400–1. https://doi.org/10.1212/wnl.39.10.1400-a.
Kalaci A, Sevinç TT, Yanat AN. Sciatica of nondisc origin: hydatid cyst of the sciatic nerve. Case report. J Neurosurg Spine. 2008;8:394–7. https://doi.org/10.3171/SPI/2008/8/4/394.
Muniz Neto FJ, Kihara Filho EN, Miranda FC, Rosemberg LA, Santos DCB, Taneja AK. Demystifying MR neurography of the lumbosacral plexus: from protocols to pathologies. Biomed Res Int. 2018;2018:9608947. https://doi.org/10.1155/2018/9608947.
Negus S, Sidhu PS. MRI of retroperitoneal collections: a comparison with CT. Br J Radiol. 2000;73:907–12. https://doi.org/10.1259/bjr.73.872.11026872.
Niazi A, Alibraheem A, Al-Mouakeh A, Abouzied MK, Basha SR, Suliman S, et al. Gluteal muscles primary hydatid cyst after cortical bone destruction in the sacrum. Ann Med Surg (Lond). 2020;59:89–92. https://doi.org/10.1016/j.amsu.2020.09.019.
Novoselova V, Lacasse A. Acute diverticulitis masquerading as unilateral sciatica-like symptoms. J Community Hosp Intern Med Perspect. 2020;10:587–90. https://doi.org/10.1080/20009666.2020.1804101.
Ozgül A, Yazicioğlu K, Gündüz S, Kalyon TA, Arpacioğlu O. Acute brucella sacroiliitis: clinical features. Clin Rheumatol. 1998;17:521–3. https://doi.org/10.1007/BF01451292.
Paley M, Sidhu PS, Evans RA, Karani JB. Retroperitoneal collections—aetiology and radiological implications. Clin Radiol. 1997;52:290–4. https://doi.org/10.1016/s0009-9260(97)80056-6.
Planner AC, Donaghy M, Moore NR. Causes of lumbosacral plexopathy. Clin Radiol. 2006;61:987–95. https://doi.org/10.1016/j.crad.2006.04.018.
Sanal HT, Kocaoglu M, Bulakbasi N, Yildirim D. Pelvic hydatid disease: CT and MRI findings causing sciatica. Korean J Radiol. 2007;8:548–51. https://doi.org/10.3348/kjr.2007.8.6.548.
Sharieff GQ, Lee DM, Anshus JS. A rare case of salmonella-mediated sacroiliitis, adjacent subperiosteal abscess, and myositis. Pediatr Emerg Care. 2003;19:252–4. https://doi.org/10.1097/01.pec.0000086237.54586.92.
Shields DW, Robinson PG. Iliopsoas abscess masquerading as ‘sciatica’. BMJ Case Rep. 2012;2012:bcr2012007419. https://doi.org/10.1136/bcr-2012-007419.
Stoeckli TC, Mackin GA, De Groote MA. Lumbosacral plexopathy in a patient with pulmonary tuberculosis. Clin Infect Dis. 2000;30:226–7. https://doi.org/10.1086/313622.
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Akhaddar, A. (2023). Pelvic and Intrapelvic Infections. In: Atlas of Sciatica. Springer, Cham. https://doi.org/10.1007/978-3-031-44984-0_89
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