Ali Hosameldeen Mostafa, Shoshan Hoda Mohamed Abdelaziz
Department of Radiology, Benha University, City, Egypt.
Department of Pathology, Benha University, City, Egypt.
BJR Case Rep. 2020 Sep 29;6(2):20190077. doi: 10.1259/bjrcr.20190077. eCollection 2020 Sep.
Iliopsoas primary tuberculous abscess is a rare clinical and imaging entity. Most reported imaging literature cases are secondary to tuberculous spondylodiscitis. Iliopsoas tuberculous inflammation and abscess constitutes a diagnostic challenge owing to its insidious onset and subtle non-specific symptoms. Here, in a case of right iliopsoas and thigh primary tuberculosis abscess complicated with right iliac bone osteomyelitis extended to the right hip joint. The conventional radiography, thigh and pelvic ultrasonography, MRI and CT examinations showed the whole right iliopsoas and thigh abscess compartments and right iliac bone osteomyelitis. No defined other pulmonary or abdominal tuberculous lesions. Percutaneous drainage of the thigh compartment under ultrasound guidance and microbiologic culture of the drained fluid elicited mycobacterium tuberculosis.
髂腰肌原发性结核脓肿是一种罕见的临床和影像学实体。大多数已报道的影像学文献病例继发于结核性脊椎椎间盘炎。髂腰肌结核性炎症和脓肿因其隐匿性起病和细微的非特异性症状而构成诊断挑战。在此,报告一例右侧髂腰肌和大腿原发性结核脓肿合并右侧髂骨骨髓炎并蔓延至右髋关节的病例。传统X线摄影、大腿和骨盆超声、MRI和CT检查显示整个右侧髂腰肌和大腿脓肿腔以及右侧髂骨骨髓炎。未发现其他明确的肺部或腹部结核病变。在超声引导下对大腿脓肿腔进行经皮引流,并对引流液进行微生物培养,检出结核分枝杆菌。