SCHEDULED DOWNTIME: We will be performing a database migration that will result in the site being unavailable for approximately 1 hour starting at UTC: Monday, 20 May 2024 11:00 PM (check your local time here

Spinal infection with accompanying epidural and psoas muscle abscess

Case contributed by Nima Azizi
Diagnosis certain

Presentation

Previously healthy female with 3-day history of lower back pain radiating down right leg and fever on the day of presentation

Patient Data

Age: 40 years
Gender: Female

MRI lumbar spine pre- and post-contrast revealed evidence of epidural collection medially and posteriorly secondary to L3/L4 septic arthritis, inflammatory changes because of facet septic arthritis are significant. 

There is also enlargement of the iliopsoas muscle noted along with a collection within the muscle. This collection is partially organized. Inflammatory changes are noted around the exiting nerve root at L3/4 and L4/5 levels. Enhancement of dura also noted in keeping with inflammatory changes

Case Discussion

The patient was taken to the theater by the orthopedic team for an urgent sampling of psoas muscle abscess.

Microbiology

Psoas abscess biopsy: Staph aureus (pan-sensitive)

Followup

The patient was ultimately treated successfully with IV antibiotics with clinical and radiological resolution.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.