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Inferior gluteal nerve

The inferior gluteal nerve is a major motor nerve of the gluteal region arising from the sacral plexus. It supplies the gluteus maximus muscle, the primary extensor of the hip, and plays a crucial role in powerful movements such as rising from sitting, climbing stairs, and running.

It is an important structure in pelvic and hip anatomy, posterior hip surgery, intramuscular injections, and imaging of the gluteal region.

Synonyms

  • Nervus gluteus inferior

  • Inferior gluteal branch of the sacral plexus

Location

  • Originates from the sacral plexus in the pelvis

  • Exits the pelvis through the greater sciatic foramen

  • Passes inferior to the piriformis muscle

  • Courses posterior to the hip joint

  • Enters the deep surface of the gluteus maximus muscle

Anatomical components

  • Roots:

    • Derived from L5, S1, and S2 spinal nerves

  • Type:

    • Pure motor nerve

  • Course:

    • Leaves pelvis via greater sciatic foramen

    • Descends posteriorly and laterally

    • Divides into branches within gluteus maximus

Relations

Anteriorly:

  • Hip joint capsule

  • Ischium

Posteriorly:

  • Gluteus maximus muscle

Superiorly:

  • Piriformis muscle

Inferiorly:

  • Quadratus femoris muscle

Medially:

  • Internal pudendal vessels and nerve (initially)

Laterally:

  • Greater trochanter region

Function

  • Motor innervation of gluteus maximus

  • Primary hip extension

  • Powerful external rotation of the thigh

  • Stabilization of the trunk during gait and climbing

  • Essential for rising from sitting and running

MRI appearance

T1-weighted images:

  • Inferior gluteal nerve: Linear or tubular low-to-intermediate signal structure

  • Surrounding fat: High signal providing contrast

  • Gluteus maximus muscle: Normal intermediate signal

T2-weighted images:

  • Nerve: Intermediate signal intensity

  • Muscle: Slightly lower signal than fat

  • Fat planes: High signal outlining the nerve course

STIR:

  • Nerve: Intermediate signal

  • Muscle and fat: Fat suppressed, improving nerve conspicuity

  • Utility: Highlights nerve course against suppressed fat background

T1 post-contrast images:

  • Nerve: Typically shows minimal or no enhancement

  • Perineural tissues and vessels: Expected enhancement

  • Helps differentiate nerve from adjacent vessels

CT appearance

Pre-contrast CT:

  • Inferior gluteal nerve: Not distinctly visualized due to soft-tissue density

  • Location inferred by relationship to piriformis and gluteus maximus

  • Fat planes: Help localize nerve pathway

Post-contrast CT:

  • Nerve: Usually not enhanced

  • Inferior gluteal vessels: Enhance prominently, serving as landmarks

MRI image

Inferior gluteal nerve MRI

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