American Board of Internal Medicine (ABIM) Certification Practice Exam

Compression of which nerve is associated with piriformis syndrome?

1. Tibial nerve

2. Common peroneal nerve

3. Sciatic nerve

4. Femoral nerve

The correct answer is: Sciatic nerve

In piriformis syndrome, the primary issue arises from the compression of the sciatic nerve. This condition occurs when the piriformis muscle, located in the buttock region, spasms or becomes tight, potentially leading to the nerve being impinged or irritated. The sciatic nerve runs close to or through the piriformis muscle in some individuals, and this anatomical relationship is crucial for understanding how symptoms develop. Patients with piriformis syndrome typically present with pain, tingling, or numbness that radiates along the distribution of the sciatic nerve, which runs down the back of the leg. Distinguishing this syndrome is important because it can mimic other conditions, such as a herniated disc or lumbar radiculopathy, but its management would differ from those conditions. Understanding the underlying anatomy and the role of the sciatic nerve in this syndrome is essential for both diagnosis and treatment.