# A Case Report of Piriformis Syndrome With Axial Spondyloarthritis in a Young Male Patient Presenting With Buttock Pain

## TL;DR

A young man with buttock pain was initially thought to have piriformis syndrome but was later diagnosed with axial spondyloarthritis after persistent symptoms.

## Contribution

The case highlights the diagnostic challenges and importance of imaging in distinguishing axial spondyloarthritis from piriformis syndrome.

## Key findings

- Initial diagnosis of piriformis syndrome failed to resolve the patient's symptoms.
- Imaging and thorough assessment led to a correct diagnosis of axial spondyloarthritis.
- The case provides guidance for differentiating axSpA from PS in clinical practice.

## Abstract

This study explores the clinical challenges in differentiating axial spondyloarthritis (axSpA) from piriformis syndrome (PS). A male patient in his 20s presented with lumbar and gluteal pain after weight-bearing. Initially diagnosed with PS, his symptoms persisted despite nonpharmacological treatment. After a thorough assessment, he was ultimately diagnosed with axSpA. This case underscores the role of imaging in differentiating axSpA from transient bone marrow edema and provides insights into distinguishing axSpA from PS in clinical practice to provide guidance for accurate diagnosis and treatment in similar complex cases.