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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).
Bursitis is the inflammation of one or more bursae (synovial sacs) of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. [1]
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]
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.
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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Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas