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Primary Psoas Abscess in a Pediatric Patient: A Case Report
Isra Idris1, Maysam Aburas2, Fernanda Ibarra Martinez1
1Pediatrics, Woodhull Medical Center, New York City, USA.
Cureus
|June 27, 2022
Summary
A psoas abscess is a pus collection in the hip flexor muscles. Early diagnosis using MRI is crucial for effective treatment, especially in children presenting with hip pain.
Area of Science:
- Infectious Diseases
- Radiology
- Pediatric Medicine
Background:
- Psoas abscesses are pus collections in the iliopsoas compartment.
- Primary abscesses result from distant infection seeding, common in children, often caused by Staphylococcus aureus.
- Secondary abscesses arise from direct spread from adjacent structures, potentially involving multiple microorganisms.
Observation:
- A five-year-old female presented with worsening right hip pain and inability to bear weight.
- Initial hip X-rays were unremarkable, but abnormal lab values suggested further investigation.
- Magnetic Resonance Imaging (MRI) revealed a right psoas abscess with surrounding edema and enhancement.
Findings:
- MRI is instrumental in diagnosing psoas abscesses, even when initial X-rays are normal.
- The case highlights the importance of considering psoas abscess in pediatric hip pain.
- Prompt imaging is key to identifying the extent and characteristics of the abscess.
Implications:
- Accurate and timely diagnosis of psoas abscesses is critical for appropriate management.
- MRI offers superior visualization for psoas abscess detection compared to conventional radiography.
- Understanding the etiology (primary vs. secondary) guides treatment strategies and prognosis.
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