psoas abscess
Introduction
Introduction Psoas muscle abscess refers to inflammation of the waist or abdominal cavity that causes the psoas muscle to infect the suppuration and form an abscess. Pain can occur: mostly mild dull pain, rest is light, tired is heavy, coughing, sneezing or holding things, but nighttime patients can sleep better, which is different from malignant tumors. The patient complained 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 the X-ray film of the lumbosacral region, it will often miss the diagnosis. If the kyphosis is severe, it can cause strain on the lower back and cause pain. If the lesion compresses the spinal cord and nerve roots, the pain can be quite intense and radiate along the nerve roots.
Cause
Cause
The cause of psoas abscess:
Lumbar or abdominal inflammation.
Examine
an examination
Related inspection
Waist back check waist activity
Examination and diagnosis of psoas abscess:
1. Pain: Mostly mild and dull pain, rest is light, tired is heavy, coughing, sneezing or holding things, but nighttime patients can sleep better, which is different from malignant tumors. The patient complained 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 the X-ray film of the lumbosacral region, it will often miss the diagnosis. If the kyphosis is severe, it can cause strain on the lower back and cause pain. If the lesion compresses the spinal cord and nerve roots, the pain can be quite intense and radiate along the nerve roots.
2. Postural abnormalities: The lesions are different, and the postures taken by the patients are different. Cervical tuberculosis patients often have torticollis deformity, head anterior oblique, neck shortening, and have been holding the lower jaw with both hands. Patients with thoracolumbar, lumbar vertebrae, and lumbar vertebrae tuberculosis should try to tilt their heads and torso when standing or walking. When sitting, they would like to use the chair to reduce the pressure on the affected vertebral body. Lumbar tuberculosis patients from the ground pick up the knees as far as possible, bend the hips, avoid bending, stand up in front of the thighs when standing up, this is called the positive test.
3. Spinal deformity: Later convex deformity is the most common, mostly angular kyphosis, side bending is not common, and not serious.
4. Spinal activity limitation: Due to the protective paralysis of the muscles around the lesion, the affected spine activity is limited, and the cervical vertebrae and lumbar vertebrae with larger motion are easy to detect, and the thoracic vertebra with less activity is not easy to detect.
The normal activities of the spine have three directions of flexion, extension, and rotation. The atlantoaxial joint mainly rotates the head. If the joint is involved, most of the head rotation function is lost. Smaller children who cannot cooperate can passively move the joint to observe restricted activities. Do not use violence during passive activities to avoid dislocation, paraplegia, or even sudden death. When examining the lumbar motion, the child is placed on the prone. The doctor lifts the feet by hand, and the pelvis is removed from the bed to observe the extension of the lumbar spine. Then the child is stretched out of the knee to observe the flexion function of the lumbar spine.
5. tenderness and sputum pain: because the vertebral body is far from the spinous process, local tenderness is not obvious; slamming local spinous processes can cause pain.
6. Cold abscess: often the earliest signs of the patient's visit, sometimes the abscess is mistaken for the tumor. Sometimes the abscess is deep and difficult to detect early, so the abscess should be found in the site of the abscess.
7. Spinal cord compression: Some patients come to see a doctor because of paraplegia. Even if the patient does not have a complaint about a neurological disorder, the doctor should routinely check the nerves of both lower extremities in order to detect early spinal cord compression in time.
Diagnosis
Differential diagnosis
Symptoms of lumbosacral abscess confusing:
According to the history, symptoms, signs, laboratory tests and X-ray findings, the diagnosis is generally difficult, but the diagnosis depends on bacteriology and pathology. The disease should be differentiated from inflammation of the spine such as suppurative osteomyelitis, rheumatoid arthritis, brucellosis, typhoid fever, syphilis, actinomycosis. In addition, it should be distinguished from spontaneous atlantoaxial dislocation, gap degeneration, osteomyelitis, lumbar disc herniation, hemivertebra deformity, congenital vertebral fusion, and spinal tumor.
