Deep gluteal syndrome: role of ultrasound in its diagnosis A 54-year-old patient with left paravertebral low back pain with gluteal and lower limb radiation of 16 months' duration. In the MRI of the hemipelvis, a fibrous band can be seen that is attached to the anterior face of the sciatic nerve, extending laterally to the greater trochanter and medially to the ischial tuberosity and the quadratus femoris muscle, corresponding to type 3 of the Hernando classification. Dynamic ultrasound is performed, which shows reduced mobility of the sciatic nerve during knee and hip extension (comparative video of normal neural mobility: facebook.com/watch/?v=497812…). Ultrasound has little value for the primary diagnosis of visualization of perineural fibrous bands, although it can often be appreciated a posteriori, guided by the findings in MRI. This could be useful for realizing fenestrations of the fibrosis after perineural infiltration using ultrasound control. The great utility of ultrasound is the assessment of the mobility of the sciatic nerve during neurodynamic exercises, which in cases where it is decreased compared to the contralateral nerve, can be used as a secondary sign for the diagnosis of DGS.

Posterior parietal insufficiency of the inguinal canal (sport hernia): ultrasound diagnosis The patient has had left pubic and groin pain for three months, which prevents him from hitting and changing direction while playing soccer. On examination, he presented pain along the inguinal canal, at the insertion of the inguinal ligament on the pubic tubercle, and the insertion of the oblique and transverse muscles on the iliac crest. To rule out sport hernia, a dynamic ultrasound of the left inguinal canal is performed during Russian twist exercise (which mainly exercises the internal oblique muscle), observing deformity and bulging of the posterior wall of the inguinal canal, unlike the asymptomatic contralateral side. The patient is referred to the abdominal wall surgery service, which performs an operation that confirms the clinical and ultrasound diagnosis.