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A rare case of primary psoas abscess causing hip pain in a patient with hip replacement

Baljinder S Dhinsa1, Hani B Abdul-Jabar2, Shanmugasundaram Rajkumar2

  • 1Queen Elizabeth Hospital, Department of Trauma and Orthopedics, London, United Kingdom. bsd14@hotmail.com.

Acta Orthopaedica Et Traumatologica Turcica
|November 28, 2014
PubMed

Insights

Revision hip replacement surgery is increasing. Psoas abscess, a rare infection, can mimic prosthetic joint infection, but successful drainage without prosthesis removal is possible.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Arthroplasty

Background:

  • Primary hip replacement surgeries are rising, leading to more revision procedures.
  • Prosthetic joint infection is a significant complication in arthroplasty.
  • Psoas abscess is a rare condition often diagnosed late, increasing patient morbidity.

Observation:

  • A patient with a total hip replacement presented with sepsis and hip pain.
  • Initial investigations for prosthetic joint infection were inconclusive.
  • An open joint washout was performed, revealing a psoas abscess without prosthesis loosening.

Findings:

  • The psoas abscess was successfully drained.
  • The patient's sepsis and hip pain resolved.
  • Revision of the hip prosthesis was not required.

Implications:

  • Psoas abscess should be considered in patients with hip pain and sepsis post-arthroplasty.
  • Early diagnosis and drainage of psoas abscess can prevent the need for prosthesis revision.
  • This case highlights a successful conservative management strategy for a rare complication.

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