Radiology case

A twelve year old female patient presented with a three history of difficulty in walking, pain in the left iliac fossa, and fever. The system review was essentially negative. A radiological investigation has been proceeded. The plain film of the abdomen, showed scoliosis of the lumbar spine concave to the left and non-visualization of the left. The ultrasound (U/S) examination revealed a hyperechoic lesion of the psoas muscle. Computed Tomography (CT) showed a hypodense rounded mass below the lower pole of the left kidney blending with a left swollen iliopsis muscle, extending into the pelvis, and reaching the left upper thigh Results have been concluded that before the advent of newer imaging techniques, the diagnosis and treatment of psoas muscle abscess was late and awaited exploratory laparatomy. U/S and CT now offer a quick and safe method for the majority case. Knowledge of the iliopsoas muscle anatomy and its fascial relationships in the retroperitoneum is mandatory for the understanding of the diagnostic and therapeutic radiological approach. 5 refs. 4 figs