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Psoas abscess is a collection of pus in the iliopsoas muscle compartment. [ 1 ] [ 2 ] It can be classified into primary psoas abscess (caused by hematogenous or lymphatic spread of a pathogen ) and secondary psoas abscess (resulting from contiguous spread from an adjacent infectious focus).
The psoas sign, also known as Cope's sign (or Cope's psoas test [1]) or Obraztsova's sign, [2] is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
The final structure of the abscess is an abscess wall, or capsule, that is formed by the adjacent healthy cells in an attempt to keep the pus from infecting neighboring structures. However, such encapsulation tends to prevent immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.
The psoas major unites with the iliacus at the level of the inguinal ligament. It crosses the hip joint to insert on the lesser trochanter of the femur. [1] The iliopsoas is classified as an "anterior hip muscle" or "inner hip muscle". [2] The psoas minor does contribute to the iliopsoas muscle.
A cold abscess can develop if infection spreads to ligaments and soft tissues. [6] [3] In the lower back, there is a chance the abscess can move down along the psoas muscle to the upper thigh and eventually break through the skin. [3]
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In case of appendicitis, signs such as fever, positive psoas sign, migration of pain from umbilicus to the right iliac fossa increases the likelihood of the disease; while signs such as vomiting before the pain reduces its likelihood to occur. [2]