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Psoas abscess in children.

S D Schwaitzberg, W J Pokorny, R S Thurston

    Journal of Pediatric Surgery
    |August 1, 1985
    PubMed
    Summary
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    Psoas abscess is often missed in children presenting with limps or abdominal pain. Early ultrasound or CT scans are crucial for diagnosis and surgical treatment, leading to full recovery.

    Area of Science:

    • Pediatric Surgery
    • Infectious Diseases
    • Diagnostic Imaging

    Background:

    • Psoas abscess is an uncommon diagnosis in children, frequently overlooked in the differential for limp or abdominal pain.
    • Delayed diagnosis can lead to prolonged investigations and specialist consultations.

    Observation:

    • Seven pediatric cases of psoas abscess, predominantly Staphylococcal, were surgically drained over seven years.
    • Initial diagnoses were often septic arthritis of the hip, ruled out by negative hip aspirations and bone scans.

    Findings:

    • While gallium scans, IVPs, and barium enemas were suggestive, ultrasound and CT scans were definitive for surgical intervention.
    • All surgically treated patients experienced improvement and recovered hip function.

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    Implications:

    • Ultrasonography and computed tomography (CT) should be considered for children with hip pain or limp after hip pathology is excluded.
    • Non-specific tests like gallium scans, IVPs, or barium enemas are insufficient to guide surgical decisions for suspected psoas abscess.