Hip Orthopaedic Test: Piriformis Test

The Piriformis Test is a physical examination test used to evaluate piriformis syndrome, which is a condition characterized by compression or irritation of the sciatic nerve by the piriformis muscle in the buttock. 

Procedure:

1. Have the patient lie on their back on an examination table, with both legs extended.
2. Ask the patient to flex their affected hip and knee to 90 degrees, with the foot flat on the table.
3. Place one hand on the patient's knee and the other hand on their ankle.
4. Gently rotate the hip externally while pushing the knee down towards the table, while keeping the ankle in a neutral position.
5. Observe the patient's reaction: If the patient feels pain or discomfort in the buttock or down the back of the leg, this may indicate compression or irritation of the sciatic nerve by the piriformis muscle.
6. Repeat the test on the other side.
7. To increase the sensitivity of the test, the clinician may try to elicit pain in the piriformis muscle by applying pressure to the muscle while performing the hip rotation.

A "normal" result for this test would be the absence of pain or discomfort in the buttock or down the back of the leg during the hip rotation. However, it is important to note that a negative test result does not necessarily rule out the presence of piriformis syndrome, as there may be other factors contributing to the patient's symptoms.

References:

1. Waldman, S. D. (2016). Physical diagnosis of pain: An atlas of signs and symptoms (3rd ed.). Elsevier.
2. Hopayian, K., & Danielyan, A. (2006). Four common types of sciatica. In Clinical Guidelines and Evidence Review for the Management of Acute Low Back Pain (pp. 117-133). Royal College of General Practitioners.
3. Manchikanti, L., Singh, V., & Falco, F. J. E. (2014). Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: a preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00355914. Pain physician, 17(4), E423-E435.
4. Russo, M. A., & Santarelli, D. M. (2014). Piriformis syndrome: a narrative review of the anatomy, diagnosis, and treatment. American Journal of Physical Medicine & Rehabilitation, 93(10), 898-908.