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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 iliopsoas is the prime mover of hip flexion, and is the strongest of the hip flexors (others are rectus femoris, sartorius, and tensor fasciae latae). [3] The iliopsoas is important for standing, walking, and running. [2] The iliacus and psoas major perform different actions when postural changes occur.
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.
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 principles of the obturator sign in the diagnosis of appendicitis are similar to that of the psoas sign. The appendix is commonly located in the retrocecal or pelvic region. The obturator sign indicates the presence of an inflamed pelvic appendix.
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The psoas major (/ ˈ s oʊ. ə s / or / ˈ s oʊ. æ s /; from Ancient Greek: ψόᾱ, romanized: psóā, lit. 'muscles of the loins') is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis.