Musculoskeletal disorders are easily mistaken for other conditions and difficult to detect.

For nearly a year, Ms. KQT (39 years old, Hanoi ) suffered from persistent pain in her left hip joint and visited many doctors without finding the cause. Only after being examined at MEDLATEC Tay Ho and being prescribed an MRI scan was she diagnosed with psoas muscle abscess, a rare condition that is easily overlooked due to its atypical symptoms.

Early diagnosis will lead to effective treatment, avoiding complications such as widespread inflammation, impaired mobility, impaired respiratory function, and reduced quality of life.

Ms. KQT, 39 years old, is an office worker living in Hanoi. For almost a year, she has suffered from persistent pain in her left hip joint, recurring in episodes, especially worsening with movement or during pregnancy. She has consulted many doctors and undergone routine health checkups, including abdominal ultrasound and urine tests, but no clear cause has been found.

The persistent pain left her exhausted and significantly impacted her daily life. It wasn't until she visited the MEDLATEC Tay Ho Multi-Specialty Clinic that her condition was accurately diagnosed.

After a thorough examination by MSc. Dr. Mac Thuy Chi, a specialist in musculoskeletal disorders, and the prescription of a series of advanced paraclinical techniques, the ultrasound results of the hip joint showed fluid accumulation and edema in the left psoas muscle.

Magnetic resonance imaging (MRI) of the hip joint clearly identified the inflammatory focus and abscess at the anterior femoral neck of the left femur. The doctor arrived at a definitive diagnosis: The patient had a left psoas muscle abscess—a not uncommon condition but one that is easily overlooked due to atypical symptoms.

Ms. T. was then advised on a treatment plan, and after just one week of intensive treatment, her pain decreased by 80%, her left hip joint moved more easily, and a follow-up ultrasound also showed a significant reduction in the size of the fluid collection.

A psoas muscle abscess is a condition in which a localized pocket of pus forms within the iliopsoas muscle, a deep muscle group that plays a crucial role in thigh flexion, maintaining body balance, and supporting the lumbar spine.

Due to its unique anatomical location, close to organs such as the intestines, kidneys, and blood vessels, this muscle is susceptible to infection spreading from surrounding areas or through the bloodstream, forming abscesses without causing pronounced symptoms.

In cases like Ms. T.'s, the main symptom is a dull ache in the groin/hip area, radiating to the front of the thigh, increasing with hip flexion, standing up, and turning. Patients usually do not have a fever, swelling, or redness, so it is easily mistaken for mechanical hip pain, spinal degeneration, sacroiliitis, etc.

There are two main groups of causes leading to psoas muscle abscesses. The first is primary, caused by bacteria migrating from the bloodstream and forming a pocket of pus, commonly seen in young, healthy individuals; the most frequently encountered bacteria is Staphylococcus aureus.

The second group is secondary, which accounts for the majority, resulting from infections spreading from neighboring organs, often seen in patients with a history of spinal tuberculosis, appendicitis, colitis, septic arthritis, urinary tract infections, discitis, etc. Blood tests may show elevated white blood cell count and CRP, clear but non-specific signs of inflammation.

From an imaging perspective, pelvic ultrasound may suggest a fluid collection; however, due to the deep location of the lesion, the sensitivity of ultrasound is limited. MRI is considered the gold standard in diagnosing this condition, allowing for clear assessment of inflammation, necrosis, and the extent of the lesion.

In Ms. T.'s case, the only clinical sign was a positive Psoas sign, pain during active or passive hip extension, which led the doctor to suspect deep muscle damage. Thanks to timely diagnosis and immediate MRI at MEDLATEC, the condition was identified and treated early, avoiding dangerous complications.

However, during treatment, one factor complicated the doctor's approach: the patient refused to have the abscess aspirated for microbiological testing to identify the causative bacteria.

This is a crucial technique for selecting the right antibiotic, especially given the increasing prevalence of multidrug-resistant bacteria in Vietnam. Empirical antibiotic treatment may provide temporary symptom relief but carries the risk of prolonging or recurring the illness.

Dr. Trinh Thi Nga, Head of the Musculoskeletal Department at MEDLATEC Healthcare System, advises that individuals experiencing persistent, unexplained, and recurring hip pain should seek specialist examination and undergo in-depth diagnostic imaging, especially MRI.

Early diagnosis leads to effective treatment, preventing complications such as widespread inflammation, impaired mobility, respiratory function, and quality of life. Ms. T.'s case is a typical example of a condition that is not uncommon but is easily overlooked if not thoroughly and properly evaluated.

Source: https://baodautu.vn/benh-ly-xuong-khop-de-nham-lan-kho-phat-hien-d373013.html