Leriche's syndrome will be seen by the podiatric physician, and it can be misinterpreted as pain secondary to mechanical etiology. Often, symptoms of buttock or thigh pain occurring during walking resemble those seen with symptomatic pronation, so this disease entity must be ruled out.
The author presents a case of a female runner with left buttock pain aggravated by exercise. She underwent extensive testing by other physicians and received cortisone injections on two occasions. The patient was referred to the podiatry department because of continued discomfort and the inability to run. Examination revealed pain on hip flexion and abduction against resistance. Because of the possibility of piriformis syndrome, she started stretching exercises, reduced her activity, and the pain disappeared. The diagnosis of piriformis syndrome was confirmed by a general surgeon.
The case presented is a rare example of subcutaneous emphysema isolated to an extremity. This is a benign condition and should not be confused with necrotizing gas-producing infections. In most cases, the condition rapidly resolves without treatment, usually in less than 48 hr. In rare cases where the mechanical process causing the subcutaneous emphysema persists, interruption of this process is required.