What Are the Symptoms of a Psoas Abscess?

The psoas major abscess is an abscess caused by inflammation of the psoas major caused by inflammation of the waist or abdomen.

Psoas muscle abscess

The psoas major abscess is an abscess caused by inflammation of the psoas major caused by inflammation of the waist or abdomen.

What causes psoas muscle abscess?

Inflammation of the waist or abdomen.

Psoas muscle abscess How should psoas muscle abscess be diagnosed?

1. Pain: mostly mild dull pain, light during rest, heavy when tired, and worse when coughing, sneezing or holding objects, but patients can sleep better at night, which is different from malignant tumors. Patients reported that the pain site was sometimes inconsistent with the lesion, and patients with thoracolumbar lesions often complained of lumbosacral pain. If you do not check carefully, or only take lumbosacral X-rays, they often miss diagnosis. Severe kyphosis can cause lower back strain and pain. If the lesion compresses the spinal cord and nerve roots, the pain may be severe and radiate along the nerve roots.

2. Posture abnormality: Different positions of patients, different postures adopted by patients. Cervical spinal tuberculosis patients often have torticollis deformity, the head is inclined, the neck is shortened, and the mandible has been supported with both hands. Patients with tuberculosis of thoracolumbar vertebrae, lumbar vertebrae, and lumbosacral vertebrae should try to tilt their heads and torso back when standing or walking. They would like to use a hand chair to reduce the pressure on the affected vertebrae. Lumbar tuberculosis patients bend their knees and hips as much as possible when picking up objects from the ground, avoid bending down, and hold their hands in front of the thighs when standing, which is called a positive pick-up test.

3. Spine deformity: kyphotic deformity is the most common, mostly angular kyphosis. Scoliosis is not common or serious.

4. Restricted spinal movement: Due to the protective spasm of the muscles around the lesion, the affected spine has limited movement. The cervical and lumbar spine with larger movements are easy to detect, and the thoracic spine with less mobility is difficult to detect.

The normal activities of the spine are flexion, extension, scoliosis and rotation. The atlantoaxial joint mainly rotates the head. If the joint is affected, most of the head's rotational function is lost. Younger children who cannot cooperate can passively move the joint to observe restricted movement. Do not use violence during passive activities to avoid dislocation, paraplegia, or even sudden death. When checking the movement of the lumbar vertebrae, the child is placed on his stomach, the doctor lifts his feet with his hands, removes the pelvis from the bed, and observes the lumbar vertebrae's extension;

5. Tenderness and throbbing pain: Because the vertebral body is far from the spinous process, local tenderness is not obvious; tapping the local spinous process can cause pain.

6. Cold abscess: It is often the earliest sign of a patient's consultation, and sometimes the abscess is mistaken for a tumor. Sometimes abscesses are deep and difficult to detect early, so you should look for abscess lesions at the site of the abscess.

7. Spinal cord compression: Some patients come to the clinic for paraplegia. Even if the patient does not have a complaint of neurological disorders, the doctor should routinely check the nerves of both lower limbs in order to detect early spinal cord compressions in time

Psoas major abscess What are the symptoms that psoas major abscess may be confused with?

According to the history, symptoms, signs, laboratory tests and X-ray findings, diagnosis is generally not difficult, but the diagnosis requires bacteriological and pathological examination. This disease should be distinguished from suppurative osteomyelitis of the spine, rheumatoid arthritis, brucellosis, typhoid fever, syphilis, actinomycosis and other inflammations. In addition, it should be distinguished from spontaneous atlantoaxial dislocation, gap degeneration, osteomyelitis, lumbar disc herniation, hemivertebral deformity, congenital vertebral fusion and spinal tumors.

1. Pain: mostly mild dull pain, light during rest, heavy when tired, and worse when coughing, sneezing or holding objects, but patients can sleep better at night, which is different from malignant tumors. Patients reported that the pain site was sometimes inconsistent with the lesion, and patients with thoracolumbar lesions often complained of lumbosacral pain. If you do not check carefully, or only take lumbosacral X-rays, they often miss diagnosis. Severe kyphosis can cause lower back strain and pain. If the lesion compresses the spinal cord and nerve roots, the pain may be severe and radiate along the nerve roots.

2. Posture abnormality: Different positions of patients, different postures adopted by patients. Cervical spinal tuberculosis patients often have torticollis deformity, the head is inclined, the neck is shortened, and the mandible has been supported with both hands. Patients with tuberculosis of thoracolumbar vertebrae, lumbar vertebrae, and lumbosacral vertebrae should try to tilt their heads and torso back when standing or walking. They would like to use a hand chair to reduce the pressure on the affected vertebrae. Lumbar tuberculosis patients bend their knees and hips as much as possible when picking up objects from the ground, avoid bending down, and hold their hands in front of the thighs when standing, which is called a positive pick-up test.

3. Spine deformity: kyphotic deformity is the most common, mostly angular kyphosis. Scoliosis is not common or serious.

4. Restricted spinal movement: Due to the protective spasm of the muscles around the lesion, the affected spine has limited movement. The cervical and lumbar spine with larger movements are easy to detect, and the thoracic spine with less mobility is difficult to detect.

The normal activities of the spine are flexion, extension, scoliosis and rotation. The atlantoaxial joint mainly rotates the head. If the joint is affected, most of the head's rotational function is lost. Younger children who cannot cooperate can passively move the joint to observe restricted movement. Do not use violence during passive activities to avoid dislocation, paraplegia, or even sudden death. When checking the movement of the lumbar vertebrae, the child is placed on his stomach, the doctor lifts his feet with his hands, removes the pelvis from the bed, and observes the lumbar vertebrae's extension;

5. Tenderness and throbbing pain: Because the vertebral body is far from the spinous process, local tenderness is not obvious; tapping the local spinous process can cause pain.

6. Cold abscess: It is often the earliest sign of a patient's consultation, and sometimes the abscess is mistaken for a tumor. Sometimes abscesses are deep and difficult to detect early, so you should look for abscess lesions at the site of the abscess.

7. Spinal cord compression: Some patients come to the clinic for paraplegia. Even if the patient does not have a complaint of neurological disorders, the doctor should routinely check the nerves of both lower limbs in order to detect early spinal cord compressions in time

How to prevent psoas muscle abscess?

Local treatment includes local braking, posterior bone graft fusion, anterior bone graft fusion, and lesion removal.

Local braking: Since the use of antituberculosis drugs, emphasis on local braking has been sufficient to rest on a hard bed. Gypsum beds have been limited to pediatric patients. For patients with stable cervical tuberculosis, cervical circumference is generally used. For example, cervical spine instability, especially atlantoaxial dislocation, and patients with concurrent spinal cord compression require Glisson traction or skull traction. Patients with lesion removal and intervertebral bone fusion are usually bed-ridden for 3 months in the cervical spine and 5-6 months in the thorax and lumbar spine. At this time, the bone grafts have been fused, and they can get up and move without the need for any stent protection. ?