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A psoas abscess is an abscess in one of the psoas muscles which extend from the lower spine into the groin. There are a number of potential reasons for one of these muscles to become abscessed, and it can sometimes be tricky to diagnose an abscess in the psoas muscle, as the symptoms are not necessarily obvious. Fortunately, the prognosis for patients with this problem is very good, especially when intervention is provided early.
A primary psoas abscess occurs when bacteria such as Staph bacteria get into the muscle, creating an area of inflammation and infection which often fills with fluid, including pus. This is most commonly seen in children, although it can appear in people of any age. A secondary abscess occurs when infection elsewhere in the body spreads to this muscle; historically, it was most commonly seen in patients with spinal tuberculosis, also known as Pott's Disease. Today, it is more commonly associated with infections of the bowels, kidneys, or spine.
A patient with a psoas abscess can experience pain in the abdomen, groin, or lower back. The patient also usually has a fever, and may experience frequent urination. The pain of the abscess can also cause gait changes, as the patient may favor the leg to avoid aggravating the pain. It is possible to diagnose an abscess with a medical imaging study of the area, in which the area of inflamed tissue will be clearly visible.
The first step in treating a psoas abscess is draining it. Historically, this was done with an open surgical procedure, but today, it is more common to insert drainage tubes with the guidance of medical imaging equipment. Along with drainage, a doctor may also provide medications to kill the bacteria in the wound, and patients may also take drugs for pain management if the abscess is extremely painful. If the abscess is very extensive, surgery may be required to debride it, removing dead tissue and cleaning the area.
Once the psoas abscess has been managed, a doctor can start to explore the causes. It is important to address the underlying condition behind the abscess, in the case of a secondary abscess, to prevent additional problems for the patient. A doctor may request additional tests, medical imaging studies, and other diagnostic tools to learn more about the patient's condition. If a problem is identified, the doctor can discuss treatment options with the patient.