Plaza R, Soriano A, Tomas X, Gallart X, Garcia S
Department of Orthopaedics and Trauma Surgery, Barcelona, Spain.
Hip Int. 2006 Jul-Sep;16(3):234-7. doi: 10.1177/112070000601600310.
Psoas abscess (PA) is an uncommon disease and its diagnosis is difficult. It can be primary or secondary. Primary abscesses are of unknown origin and are presumably caused by haematogenous or lymphatic spread from a distant infectious focus. Secondary PA is caused by spreading from a contiguous infected structure, such as vertebrae (espondilodiscitis) or mesenteric abscesses (Crohns disease). PA infrequently has been associated with an infection of total hip arthroplasty (ITHA). The correct diagnosis in these cases is difficult due to the clinical similarities between PA and ITHA. Since connection between PA and ITHA is established through the acetabulum, we consider that computed tomography (CT) is the most accurate radiological test because of its efficacy in evaluating the bone structure, and the optimum therapeutic strategy is two-stage replacement surgery. We report one case of PA associated with ITHA and a review of the previous literature.
腰大肌脓肿（PA）是一种罕见疾病，其诊断较为困难。它可以是原发性的，也可以是继发性的。原发性脓肿病因不明，推测是由远处感染灶经血行或淋巴播散所致。继发性PA是由相邻感染结构蔓延引起的，如椎体（脊椎椎间盘炎）或肠系膜脓肿（克罗恩病）。PA很少与全髋关节置换术感染（ITHA）相关。由于PA和ITHA在临床上有相似之处，这些病例的正确诊断很困难。由于PA和ITHA是通过髋臼建立联系的，我们认为计算机断层扫描（CT）是最准确的影像学检查，因为它在评估骨骼结构方面有效，而最佳治疗策略是两阶段置换手术。我们报告一例与ITHA相关的PA病例，并对既往文献进行综述。
