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Case Reports
. 2021 Feb 5;13(2):e13162.
doi: 10.7759/cureus.13162.

Psoas Abscess Presented as Right Hip Pain in a Young Adult With Crohn's Disease

Sotirios G Doukas  1   2 , Keshav Bhandari  2 , Kim Dixon  2
Affiliations
Case Reports

Psoas Abscess Presented as Right Hip Pain in a Young Adult With Crohn's Disease

Sotirios G Doukas et al. Cureus. .

Abstract

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.

Keywords: crohn’s disease (cd); hip pain; psoas abscess.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Computed tomography of the abdomen with and without oral and intravenous contrast showing a fistulous connection between the terminal ileum and the right psoas major (star).
This was markedly edematous and inflamed and contained phlegmon/abscess (arrow).
See this image and copyright information in PMC

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