Subgluteal Space and Associated Disorders

Abstract

There are four sources of posterior extra-articular hip pain for which the surgeon should be aware: deep gluteal syndrome (sciatic nerve entrapment), hamstring pathology, pudendal nerve, and ischiofemoral impingement. A structured hip examination is key to the assessment of patients presenting with posterior hip pain. A comprehensive examination should encompass the four layers of the hip, the osseous, capsulolabral, musculotendinous, and neurovascular, and consideration should be given to the fifth layer, the kinematic chain. This chapter discusses the pertinent anatomy, relevant biomechanics, key clinical diagnostic strategies, and evaluation of posterior hip pathology in the development of a treatment plan for deep gluteal syndrome (sciatic nerve entrapment), hamstring pathology, pudendal nerve, and ischiofemoral impingement, as a part of a comprehensive treatment strategy.