The Piriformis test is performed with the hip flexed to 70-80 degrees, knee flexed, and the leg maximally adducted; positive sign is pain in which region?

• A. Pain in the knee
• B. Pain in the thigh
• C. Pain in the buttock
• D. Pain in the groin

Answer: (C)

The test stresses the piriformis muscle and the nearby sciatic nerve by placing the hip in about 70–80 degrees of flexion with the knee bent and the leg moved toward the midline. If the piriformis is tight or irritated, this position can compress or irritate the sciatic nerve as it runs through or beneath the muscle, producing pain felt in the buttock. Pain in the buttock fits with piriformis-related sciatic nerve irritation, whereas pain in the knee or groin would point to other structures, and thigh pain would be less specific to piriformis syndrome.