Ultrasound-guided sciatic nerve block in a patient with sciatic neuropathy associated with uterine myoma: a case report

While sciatica is commonly associated with lumbar spinal issues, it is important to acknowledge that non-spinal factors can also play a significant role. Particularly in female patients, gynecologic conditions can lead to secondary sciatic neuropathy. A 66-year-old woman experienced posterolateral right lower extremity radiating pain. We initially performed a lumbar transforaminal epidural steroid injection, but the pain persisted. A hip MRI was conducted for further evaluation, revealing sciatic neuropathy adjacent to the pedunculated portions of uterine myoma. Subsequently, we performed a sub-gluteal sciatic nerve block under ultrasound guidance, resulting in significant relief of her pain. In conclusion, a Hip MRI can be helpful for the differential diagnosis of sciatica, and ultrasound-guided sciatic nerve block can be considered an appropriate and effective treatment option.