The Pitfall of Low Back Pain - Psoas Abscess

Authors

Pei-Dery Sheu
Jue-Long Wang
Shwu-Fen Sun
Chiao-Wen Hwang
Kuen-Huang Chen

Translated Title

急性下背痛的陷阱：腰大肌膿瘍

Abstract

The clinical presentation of psoas abscess is variable and nonspecific. The triad of fever, flank pain, and limitation of hip movement, which is specific for psoas abscess, is present in only less than 30% of the cases. Therefore, delayed diagnosis or misdiagnosis, resulting in the high mortality and morbidity, is not uncommon. A primary psoas abscess has no obvious focus of infection. It is believed that hematogeneous spread occurs from an occult source, analogous to acute osteomyelitis. Hematoma due to trauma may be the pathogenesis. The most common pathogen is staphylococcus. Secondary psoas abscess is defined as occurring by direct spread from contiguous structures. Several causes are described, including Crohn’s disease, appendicitis, diverticulitis, disc infection and spondylitis. Percutaneous or open drainage of psoas abscess combined with appropriate antibiotic therapy is highly successful treatment. In cases of secondary psoas abscess, further investigation for the underlying disease and subsequent surgery is necessary for the prevention of the recurrence.Here what we discuss remind clinicians, the approach with acute low back pain patient who presents the classical triad of psoas abscess, requiring high index of suspicion. Therefore, the patient could be diagnosed and managed as early as possible.

Language

Traditional Chinese

First Page

103

Last Page

110

Recommended Citation

Sheu, Pei-Dery; Wang, Jue-Long; Sun, Shwu-Fen; Hwang, Chiao-Wen; and Chen, Kuen-Huang (2002) "The Pitfall of Low Back Pain - Psoas Abscess," Rehabilitation Practice and Science: Vol. 30: Iss. 2, Article 6.
DOI: https://doi.org/10.6315/3005-3846.2161
Available at: https://rps.researchcommons.org/journal/vol30/iss2/6