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An easily overlooked presentation of malignant psoas abscess: hip pain

Ayhan Askin1, Korhan Baris Bayram1, Umit Secil Demirdal1

  • 1Katip Celebi University, Ataturk Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, 35360 Izmir, Turkey.

Case Reports in Orthopedics
|February 17, 2015
PubMed

Insights

Psoas abscess, a rare infection, presents subtly, often delaying diagnosis. This case highlights a secondary psoas abscess in a patient with metastatic cervical carcinoma.

Area of Science:

  • Infectious Diseases
  • Oncology
  • Radiology

Background:

  • Psoas abscess is a rare infectious disease with nonspecific clinical presentation, leading to diagnostic challenges.
  • Its insidious onset and occult characteristics contribute to diagnostic delays.
  • Psoas abscess is classified as primary or secondary, with Staphylococcus aureus being the most common pathogen in primary cases.

Purpose of the Study:

  • To present a case of secondary psoas abscess in a patient with metastatic cervical carcinoma.
  • To emphasize the importance of clinical suspicion and imaging in diagnosing psoas abscess.
  • To discuss the implications of delayed treatment for psoas abscess.

Main Methods:

  • Case report presentation.
  • Review of patient history, clinical presentation, and diagnostic imaging.
  • Discussion of psoas abscess classification and etiology.

Main Results:

  • A 54-year-old patient presented with severe hip pain.
  • An abscess in the psoas muscle was diagnosed, secondary to metastatic cervical carcinoma.
  • The case underscores the potential for psoas abscess to arise from underlying malignancies.

Conclusions:

  • Secondary psoas abscess can be a complication of advanced metastatic disease.
  • Prompt diagnosis and treatment of psoas abscess are crucial to reduce morbidity and mortality.
  • A high index of clinical suspicion is essential for timely diagnosis, especially in patients with risk factors or underlying conditions.

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