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Conclusion
In our series, we have placed emphasis on myofascial origin in nearly 90% of our patients. We believe periosteitis, in addition to tendonitis, plays an important part in the etiology of this syndrome.
This is a unique but relatively straightforward condition, possibly affecting millions of patients. Physical examination of the abdomen, thorough examination of the surrounding bony points, and completion of pelvic and rectal exams, keeping in mind the signs we have described under “Diagnosis,” result in good reasons for the an initial diagnosis of POPSS Syndrome. Confirmation of this diagnosis and treatment objectives are achieved simultaneously with strategically placed steroid injections.
Making a swift diagnosis and administering appropriate, conservative treatment can save literally billions of dollars. Also, both pain and suffering and the cost of lost productivity can be minimized. I think we are still in the learning phase about this enigmatic condition, and much research needs to be done to streamline our approach and minimize or eliminate unnecessary investigations, invasive procedures, and, sometimes, unnecessary operations.
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