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Piriformis Tendon

tendo musculi piriformis

The piriformis tendon inserts on the superior greater trochanter and is the most clinically significant deep hip external rotator tendon because of its relationship to the sciatic nerve. The sciatic nerve passes below the piriformis in 85 percent of people, through it in 10 percent, and above it in 5 percent — the anatomical basis of piriformis syndrome. Piriformis tendinopathy produces deep buttock pain reproduced by hip external rotation.

Region: Pelvis & Hip

Biomechanics

Function & Actions

Hip external rotation; sciatic nerve relationship during hip rotation

Clinical Relevance

Clinical Notes

Piriformis injection targeting the muscle-tendon unit at the greater trochanter insertion is performed under ultrasound or CT guidance for piriformis syndrome confirmation and treatment. Piriformis release surgery divides the piriformis tendon near its greater trochanter insertion to decompress the sciatic nerve in confirmed piriformis entrapment unresponsive to conservative management.

Pathology

Common Injuries & Conditions

Piriformis Tendinopathy

Deep buttock pain from piriformis tendon overload reproduced by the FAIR test (Flexion, Adduction, Internal Rotation) and managed with targeted injection and rehabilitation.