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This narrative review explores its diagnostic challenges and highlights the role of advanced imaging techniques in improving diagnostic accuracy. Literature suggests that PS may account for 5% to 8% of low back pain cases, frequently manifesting as buttock pain exacerbated by sitting or hip motion. Traditional imaging often fails to detect PS due to nonspecific findings, but magnetic resonance neurography can reveal sciatic nerve inflammation. A multimodal approach combining clinical assessment with targeted imaging enhances diagnostic precision and guides effective management of PS.<\/jats:p>","DOI":"10.1177\/15563316251392059","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T07:31:16Z","timestamp":1764401476000},"page":"192-196","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Piriformis Syndrome Is Often Overlooked as a Cause of Gluteal Pain and Sciatica: Diagnostic Challenges and the Role of Imaging\u2014A Narrative Review"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7486-1087","authenticated-orcid":false,"given":"Hamza M.","family":"Alrabai","sequence":"first","affiliation":[{"name":"Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-8321","authenticated-orcid":false,"given":"Yousef","family":"Alrashidi","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Surgery, College of MedicineTaibah University, Medina, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0016-0201","authenticated-orcid":false,"given":"Rakan Abdulkarim A.","family":"AlEtebi","sequence":"additional","affiliation":[{"name":"College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2561-346X","authenticated-orcid":false,"given":"Taher Mohammed A.","family":"Mufti","sequence":"additional","affiliation":[{"name":"College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Yousef A.","family":"Alali","sequence":"additional","affiliation":[{"name":"College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz Saad A.","family":"Alnazhan","sequence":"additional","affiliation":[{"name":"College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Al-Al-Shaikh M Michel F Parratte B Kastler B Vidal C Aubry S. 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