Psoas abscess in rheumatoid arthritis--an inperspicuous diagnosis

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A H Isdale1, D F Foley-Nolan, W P Butt

  • 1Rheumatology and Rehabilitation Research Unit, Leeds.

British Journal of Rheumatology
|September 1, 1994
PubMed

Insights

Psoas abscess, a rare condition, can present subtly with back pain and fever, especially in rheumatoid arthritis (RA) patients. Early recognition is crucial for timely treatment of this challenging diagnosis.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Diagnostic Imaging

Background:

  • Psoas abscess is an uncommon condition, often overlooked in clinical practice.
  • Rheumatoid arthritis (RA) patients may present with atypical symptoms, complicating diagnosis.
  • Back pain and pyrexia are key presenting symptoms that warrant further investigation.

Observation:

  • Two rheumatoid arthritis (RA) patients presented with predominant back pain and subsequent pyrexia.
  • The diagnosis of psoas abscess was not immediately evident in these cases.
  • The clinical presentation highlighted diagnostic challenges associated with psoas abscess.

Findings:

  • Psoas abscess can manifest insidiously, particularly in patients with underlying inflammatory conditions like RA.
  • Delayed diagnosis can occur due to non-specific symptoms such as back pain.
  • Pyrexia in RA patients can indicate serious underlying infections like psoas abscess.

Implications:

  • Clinicians should maintain a high index of suspicion for psoas abscess in RA patients with back pain and fever.
  • Prompt diagnostic workup, potentially including imaging, is essential for accurate and timely diagnosis.
  • Awareness of this infrequent but serious condition can improve patient outcomes.

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