• Ju Young Cho, Hyunseok Moon, Sungwon Park, Byung Joo Lee, and Donghwi Park.
• Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of South Korea.
• Medicine (Baltimore). 2019 May 1; 98 (19): e15488.

IntroductionAn isolated injury to the tibial division is rare among compressive sciatic neuropathy. To date, isolated injury to the tibial division of the sciatic nerve after self-massage of the gluteal muscle has not been reported. Here, we report a case of compressive sciatic neuropathy diagnosed after self-massage of the gluteal muscle using magnetic resonance image (MRI) and ultrasound images and its associated therapeutic process.Patient ConcernsA 50-year-old woman presented right lower extremity pain for the past 7 days.DiagnosisElectrophysiological findings were consistent with right tibial neuropathy proximal to the branch to hamstring muscles. However, T2-weighted MRI showed high signal intensity and swelling in the right sciatic nerves from the superior gemellus level to the quadratus femoris level. After considering both radiologic and electrophysiological findings, the patient was diagnosed with an isolated injury to the tibial division of the right sciatic nerve.InterventionsThe patient agreed to an ultrasound-guided perineural steroid injection upon receiving detailed explanation of the procedure.OutcomesAfter the injection, there was significant improvement in pain.ConclusionTherefore, in making a diagnosis of sciatic neuropathy, it may be important to find the lesion via MRI than relying solely on the patient's history or electrophysiologic study.

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