A 30-Year-Old Man Is Evaluated for 6 Months of Persistent

question 46

Multiple Choice

A 30-year-old man is evaluated for 6 months of persistent pain in his right buttock and posterior thigh.  He is a construction worker and has difficulty lifting heavy objects or climbing stairs.  He has no history of back injury and no associated back pain.  Past medical history is unremarkable.  The patient does not use tobacco and drinks only moderate quantities of alcohol.  On examination, the patient develops pain with forced adduction of the flexed thigh and internal rotation of the extended thigh against resistance.  Further evaluation reveals possible entrapment of the sciatic nerve in the greater sciatic foramen.  Which of the following structures passes through the foramen and occupies most of its volume?

• A)Coccygeus muscle
• B)Gluteus minimus muscle
• C)Obturator internus muscle
• D)Piriformis muscle
• E)Sacrospinous ligament
• F)Sacrotuberous ligament

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