Piriformis Syndrome?

[takajokomo]

I have a patient with symptoms suggestive of piriformis syndrome. after 2 weeks of treatment with illiopsoas and piriformis stretching, utrasound to piriformis, and hip extensor strengthening on the affetecd side, symptoms have improved a bit but continue to persist.

She also presents with right anterior groin pain when the bladder is full, has excessive hip external rotation at rest and a mild pes cavus on weight bearing (possibly from the external hip rotation).

Could this be a genuine case of piriformis syndrome? Or are there other differential diagnoses I should consider?

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