Psoas muscle abscess presenting as lumbar hernia

Case contributed by Dr Maulik S Patel

Presentation

Known case of tuberculous spondylitis - 8 mths back. Treatment defaulter. C/o left lumber swelling - Few days.

Patient Data

Age: 25 yrs
Gender: Male

L4-L5 disc space reduction with erosion of inferior end plate of L4 vertebra.

Contous bulge is noted in left psoas shadow.

An abscess with tiny wall calcification is noted involving left psoas muscle.

It herniates into lumbar region and enters in subcutaneous plane.

Communication between larger subcutanous abscess and relatively smaller 'psoas' abscess is visible.

Case Discussion

Findings favor psoas abscess presenting as lumbar hernia.

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