Azizi Lamia, Jaber Rachid, Faddoul Sami
Radiology Department, University of Balamand, El-Koura, Lebanon.
Doctors Center Laboratory and Radiology, Hamra, Beirut, Lebanon.
Radiol Case Rep. 2024 Aug 7;19(10):4622-4626. doi: 10.1016/j.radcr.2024.07.040. eCollection 2024 Oct.
This report documents a rare case of a sequestered disc in the psoas muscle mimicking an intramuscular abscess, notable for its lack of systemic infection indicators and resolution without surgical intervention. Such cases emphasize the need for accurate differential diagnosis and highlight potential conservative management pathways for sequestered disc herniations. A 57-year-old male presented with acute low back pain following minor weight lifting, unresponsive to NSAIDs. MRI and CT imaging, followed by CT-guided aspiration and cultures, were employed to investigate a nodular structure within the right psoas muscle. Initial imaging suggested an infectious etiology; however, aspiration yielded no material, and cultures were negative. Follow-up MRIs demonstrated improvement and eventual resolution of the lesion, supporting a diagnosis of sequestered disc herniation. This case underscores the importance of considering differential diagnoses for psoas abscess-like presentations and suggests that conservative management may be sufficient in certain cases of sequestered disc fragments.
本报告记录了一例罕见病例,即腰大肌内的游离椎间盘酷似肌内脓肿,其显著特点是缺乏全身感染指标且未经手术干预即自行消退。此类病例强调了准确鉴别诊断的必要性,并突出了游离椎间盘突出症潜在的保守治疗途径。一名57岁男性在轻微举重后出现急性腰痛,对非甾体抗炎药无反应。采用MRI和CT成像,随后进行CT引导下穿刺抽吸及培养,以研究右腰大肌内的结节状结构。初始成像提示为感染性病因;然而,抽吸未获得任何物质,培养结果为阴性。后续MRI显示病变有所改善并最终消退,支持游离椎间盘突出症的诊断。该病例强调了对类似腰大肌脓肿表现进行鉴别诊断的重要性,并表明在某些游离椎间盘碎片病例中保守治疗可能就足够了。