Psoas Abscess in Rheumatoid Arthritis—an Inperspicuous Diagnosis

Isdale, A.; Foley-Nolan, Darragh; Butt, Wasi Haider; Birkenhead, D.; Wright, Valena

doi:10.1093/rheumatology/33.9.853

Cited by 11 publications

(12 citation statements)

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“…In the secondary type, underlying causative factors are identified and the abscess is usually caused by enteric bacteria such as E. coli and Bacteroides 4–6 . Mycobacterium tuberculosis infection of the spine, Pott's disease, is currently the most frequent cause of secondary psoas abscess in developing countries 4 7. The commonest associated conditions in secondary type are Crohn's disease, diverticulitis, appendicitis, colorectal cancer, urinary tract infection, vertebral osteomyelitis, mycotic abdominal aortic aneurysm and endocarditis 4–6.…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory investigations, in general, are not specific in diagnosing psoas abscess. Leucocytosis, elevated C reactive protein, anaemia and raised erythrocyte sedimentation rate are frequently reported 7 10. Blood cultures may be positive, and some reviews refer to positivity in about 50% of patients 7.…”

Section: Discussionmentioning

confidence: 99%

“…Leucocytosis, elevated C reactive protein, anaemia and raised erythrocyte sedimentation rate are frequently reported 7 10. Blood cultures may be positive, and some reviews refer to positivity in about 50% of patients 7. Initial radiological investigations may include plain radiographs, which are normally unremarkable, unless underlying discitis or vertebral osteomyelitis have been present for the previous few weeks.…”

Section: Discussionmentioning

confidence: 99%

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Just another abdominal pain? Psoas abscess-likemetastasis in large cell lung cancer with adrenal insufficiency

Bernardino

Val-Flores²,

Dias

et al. 2015

BMJ Case Reports

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The authors report the case of a 69-year-old man with chronic obstructive pulmonary disease and previous pulmonary tuberculosis, who presented to the emergency department with abdominal and low back pain, anorexia and weight loss, rapidly evolving into shock. An initial CT scan revealed pulmonary condensation with associated cavitation and an iliopsoas mass suggestive of a psoas abscess. He was admitted in an intensive care unit unit; after a careful examination and laboratory assessment, the aetiology was yet undisclosed. MRI showed multiple retroperitoneal lymphadenopathies, bulky nodular adrenal lesions and bilateral iliac lytic lesions. Hypocortisolism was detected and treated with steroids. A CT-guided biopsy to the psoas mass and lytic lesions identified infiltration of non-small lung carcinoma. The patient died within days. Psoas metastases and adrenal insufficiency as initial manifestations of malignancy are rare and can be misdiagnosed, particularly in the absence of a known primary tumour.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Just another abdominal pain? Psoas abscess-likemetastasis in large cell lung cancer with adrenal insufficiency

Bernardino

Val-Flores²,

Dias

et al. 2015

BMJ Case Reports

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show abstract

“…Mycobacterium tuberculosis infection of the spine, known as Pott's disease, is the most frequent cause of secondary psoas abscess in developing countries. [6] Other conditions associated with secondary psoas abscess include Crohn's disease, diverticulitis, appendicitis, colorectal cancer, urinary tract infection, vertebral osteomyelitis, mycotic abdominal aortic aneurysm, endocarditis, and history of instrumentation in or around the spine. Bilateral psoas abscess occurs in just 3% of all cases, primary or secondary.…”

Section: Discussionmentioning

confidence: 99%

Bilateral extensive tubercular iliopsoas abscess: An uncommon manifestation of Pott′s spine

Sharma

Suhani

Ali

et al. 2015

Ann Trop Med Public Health

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Bilateral iliopsoas abscess is an uncommon presentation of Pott's spine. We recently cared for a young, immunocompetent male who presented with a right paravertebral swelling. He had been on antitubercular therapy (ATT) for 6 months for pulmonary tuberculosis. On computerized tomography (CT), the patient was found to have Pott's spine as the primary pathology with extensive iliopsoas abscesses bilaterally. The aspirate from the swelling grew Mycobacterium tuberculosis, which was resistant to isoniazid and rifampicin. He was then started on appropriate drugs according to sensitivity reports. Our patient was a rare case of a young, immunocompetent male who presented with large bilateral psoas involvement due to Pott's spine. This was not associated with any neurological de icit. The organisms were multidrug-resistant, even though the pulmonary lesions had resolved after being on ATT for 6 months. To conclude, for any tubercular patient presenting with paravertebral abscess or back pain, Pott's spine should be considered among the differential diagnoses, especially in endemic regions. Tubercular culture and sensitivity should be done in all such cases due to the widespread prevalence of drug-resistant forms.

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“…Regarding psoas abscesses associated with autoimmune disease, Isdale et al 8 reported only two patients with a psoas abscess in RA. However, some patients with autoimmune diseases may have psoas abscesses when they suffer from fever of unknown origin.…”

Section: Discussionmentioning

confidence: 99%

A case of psoas abscess in a patient with systemic sclerosis and rheumatoid arthritis

Tsuji¹,

Ihata²,

Saito³

et al. 2001

Modern Rheumatology

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We report a case of psoas abscesses associated with systemic sclerosis and rheumatoid arthritis. A 61year-old woman had been sufferring from high fever. A computed tomography (CT) scan revealed bilateral psoas abscesses from which Peptostreptococcus spp. were detected by a culture of the pus. The abscesses were ameliorated by performing CT-guided percutaneous drainage and using appropriate antibiotics. Although psoas abscess is relatively rare, it can be a cause of fever of unknown origin in collagen diseases.

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Psoas Abscess in Rheumatoid Arthritis—an Inperspicuous Diagnosis

Cited by 11 publications

References 0 publications

Just another abdominal pain? Psoas abscess-likemetastasis in large cell lung cancer with adrenal insufficiency

Just another abdominal pain? Psoas abscess-likemetastasis in large cell lung cancer with adrenal insufficiency

Bilateral extensive tubercular iliopsoas abscess: An uncommon manifestation of Pott′s spine

A case of psoas abscess in a patient with systemic sclerosis and rheumatoid arthritis

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