Doukas Sotirios G, Bhandari Keshav, Dixon Kim
Department of Forensic Sciences and Laboratory of Toxicology, University of Crete Medical School, Giofirakia, GRC.
Department of Medicine, Saint Peter's University Hospital, New Brunswick, USA.
Cureus. 2021 Feb 5;13(2):e13162. doi: 10.7759/cureus.13162.
A 27-year-old man with a past medical history of Crohn's disease presented in the Emergency Department complaining of right hip pain that has been going on for one month. At presentation, the patient was tachycardic. Physical examination revealed a positive psoas sign. Laboratory tests showed elevated white blood cells, C-reactive protein, and erythrocyte sedimentation rate. Computed tomography of the abdomen and pelvis revealed ileo-psoas fistula and psoas abscess. This rare case aims to provide awareness that intra-abdominal pathology should always be suspected in patients with referred hip pain and Crohn's disease. A thorough physical examination including maneuvers for assessment of possible iliopsoas inflammation should be effectively performed at the bedside to determine the likelihood of the condition and proper imaging should follow to confirm the diagnosis.
一名27岁有克罗恩病病史的男性患者因右髋部疼痛持续1个月而到急诊科就诊。就诊时，患者心动过速。体格检查发现腰大肌征阳性。实验室检查显示白细胞、C反应蛋白和红细胞沉降率升高。腹部和骨盆计算机断层扫描显示回肠腰大肌瘘和腰大肌脓肿。这个罕见病例旨在提醒大家，对于有牵涉性髋部疼痛和克罗恩病的患者，应始终怀疑存在腹内病变。应在床边有效进行全面的体格检查，包括评估可能的髂腰肌炎症的手法检查，以确定病情可能性，随后应进行适当的影像学检查以确诊。
