Piriformis Syndrome (PS) is a condition affecting the piriformis muscle, located deep within the buttock. Overuse or irritation of this muscle can lead to compression or irritation of the adjacent sciatic nerve, causing pain in the buttock, thigh, and leg. PS is diagnosed in 2-6% of patients with low back pain or sciatica, but incidence can be as high as 17.2%.Diagnosis of PS is based on physical examination and clinical information, with imaging studies used to rule out other diseases. However, differentiating PS from other neurological pain-causing conditions like lumbar radiculopathy or sciatica can be challenging due to similar symptoms.Military pilots often experience chronic back pain and radiating pain due to body positioning discomfort and high gravity force. Lumbar disc herniation is common in this group, leading doctors to often suspect this condition when diagnosing radiating lower extremity pain in pilots. However, this case report of a military fighter pilot with a history of chronic lumbar radiculopathy diagnosed with PS highlights the importance of considering all potential diagnoses. This serves as a reminder for healthcare professionals to maintain a broad differential diagnosis to ensure accurate and effective treatment.

Dong Hyuck Kim (MD) is an assistant professor of Anesthesiology and Pain Medicine at Daegu Catholic Medical Center. Now he currently devotes one day a week as a researcher, one day a week as a pain physician, three days a week as an anesthesiologist, one day a week as an athlete who enjoys a variety of sports, and one day a week as a philosopher who ponders the meaning of life.