Psoas abscess

Case contributed by Narayanan Ramakrishna
Diagnosis probable

Presentation

Pain in the left flank with fever since 3 months.

Patient Data

Age: 45 years
Gender: Male
Annotated image

Plain radiograph of abdomen shows an intact right psoas muscle shadow, while the shadow of left psoas muscle is not visualised with a large radiopacity seen in left lumbar region. 

On CT, there is a large bilobed peripherally enhancing collection seen in the upper 2/3rd of left psoas muscle, extending into left pararenal space (red arrow). The collection is displacing the left kidney superiorly and there is also associated thickening of the lateroconal fascia.

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