Acute iliopsoas and adductor brevis abscesses presenting with proximal leg muscle weakness

Chalaupka, Flavio Devetag

doi:10.1007/s10072-006-0613-z

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…The surrounding tissues are frequently indurated and woody to palpation (cases 1 and 3 exhibited inflammatory signs in the adductor muscles). Thigh pain (cases 4 and 5) is a rare symptom that has been described in cases of infection of the obturator internus [11, 16], but also of the psoas and the adductor muscles [6].…”

Section: Discussionmentioning

confidence: 99%

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Primary obturator-muscle pyomyositis in immunocompetent children

García-Mata

Hidalgo-Ovejero

Esparza-Estaun

2012

Journal of Children's Orthopaedics

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Purpose Primary pyomyositis in immunocompetent children in non-tropical regions (countries with temperate climates) is very uncommon. It is rarely found in the intrapelvic muscles, and even more rarely in the obturator muscles. We try to draw attention to the potential occurrence in these conditions. Methods Five new cases of primary obturator-muscle pyomyositis in immunocompetent children aged between 6 and 11 years in a temperate climate are presented. They present with symptoms as follows: fever, pain (thigh, abdominal, inguinal, and/or hip pain), and limp. Three of them had no hip movement limitation. All of them had tenderness in the perineum zone. Results Laboratory tests may reveal high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) counts, but depend on the length of diagnostic delay. The evolution time oscillated from 1 to 5 days. Fever and limp disappearance depends on the evolution time previous to the onset of the antibiotics administration. In 4 out of 5 patients, Staphylococcus aureus was present in the blood cultures. In all cases of obturator-muscle pyomyositis, diagnosis was confirmed using computed tomography (CT) scan (one) and/or magnetic resonance imaging (MRI) (four). Conclusions Obturator-muscle pyomyositis is aimed at emphasizing the diagnostic difficulties associated with the condition, due to its deep location and to the fact that the disease presents with multiple manifestations that may initially cause confusion, since they mimic other conditions occurring in the abdomen, hip (septic arthritis, osteomyelitis), spine, etc. The diagnosis is only confirmed using CT scan and/or MRI. In the five patients with antibiotics treatment, the condition resolves without sequelae, even at long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

“…It is rare in older people, in whom it is usually associated with diabetes [4]. Its most frequent anatomic locations are the quadriceps muscle (26.3 %) and the iliac psoas muscle (14 %) [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Primary obturator-muscle pyomyositis in immunocompetent children

García-Mata

Hidalgo-Ovejero

Esparza-Estaun

2012

Journal of Children's Orthopaedics

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“…Rarely, psoas abscess can extend to the adductors of the lower extremities, as we found (unilaterally) in our patient. Chalaupka reported a 77-year-old woman with concomitant abscesses of the psoas and adductor brevis muscles[4]. In our case, the abscess extended farther, involving the entire set of adductors of the left thigh.…”

Section: Discussionmentioning

confidence: 58%

Primary psoas abscess extending to thigh adductors: case report

Zhou

Song

Cai

2010

BMC Musculoskelet Disord

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BackgroundPsoas abscess is a rare condition consisting of pyomyositis of the psoas. The worldwide incidence was 12 cases per 100,000 per year in 1992, but the current incidence is unknown. Psoas abscess can descend along the psoas sheath and reach the inner upper third of the thigh, but only infrequently does it penetrate the sheath and involve the thigh adductors. Because of insidious clinical presentation, the diagnosis of psoas abscess is a challenge. Delayed diagnosis can result in poor prognosis.Case presentationA 45-year-old male with no significant past medical history presented with pain in the left thigh, and limitation of movement at the left hip and knee joint for one month. Ultrasound, CT, and MRI revealed a liquid mass in the left psoas. Percutaneous drainage of this mass yielded 300 ml pus from the psoas. After surgery, the patient reported relief of pain; however, ten days after removal of the drainage tube, the patient complained of persistent pain in his left thigh. CT revealed that the psoas abscess had extended inferiorly, and involved the entire set of adductors of the left thigh. Open surgical drainage was performed at the flank and at the thigh, yielding 350 ml of pus from the thigh. After open drainage and adequate antibiotic therapy, the patient made a good recovery. Follow-up CT confirmed complete resolution of the abscess.ConclusionsLarge psoas abscess can penetrate the psoas sheath, and descend to thigh adductors even after percutaneous drainage. Appropriate treatment includes open surgical drainage along with antibiotic therapy.

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“…Pyomyositis is relatively more common in children, and has an equal sex distribution. In rare cases, psoas abscesses can extend to the adductors [2]. Acute primary abscess or polymyositis is rare in the western world [3], and is more prevalent in tropical countries.…”

Section: Discussionmentioning

confidence: 99%

Acute pyomyositis of the adductor magnus muscle involving the posterior and lateral thigh compartments: a case report of diagnosis and management

et al. 2022

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Bacterial infection of skeletal muscle can lead to the formation of abscesses. Primary pyomyositis is typically seen in tropical countries, and Staphylococcus aureus is the commonest causative organism. We present a case of acute adductor magnus muscle abscess (pyomyositis) with spread to adjacent thigh compartments via the perforators without iliopsoas muscle involvement. Due to the involvement of the entire thigh compartment, systemic antibiotic treatment alone was insufficient, whereas surgical drainage improved the clinical picture. The aetiological organism was S. aureus. Herein, we report the case of a patient who had primary pyomyositis, rather than a secondary type, that spread to the posterior and lateral aspect of the thigh through the second and third perforators, which pierce the adductor magnus muscle belly before entering the femur.

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Acute iliopsoas and adductor brevis abscesses presenting with proximal leg muscle weakness

Cited by 5 publications

References 15 publications

Primary obturator-muscle pyomyositis in immunocompetent children

Primary obturator-muscle pyomyositis in immunocompetent children

Primary psoas abscess extending to thigh adductors: case report

Acute pyomyositis of the adductor magnus muscle involving the posterior and lateral thigh compartments: a case report of diagnosis and management

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