Most responders recommended aspiration and suggested these abscesses might
be secondary to infectious spondylitis/discitis (e.g. TB).
One OCADer suggested diabetic myonecrosis as a differential, which I also
find very helpful.
I tried aspirating but couldn’t get anything out with an 18G needle.
[image: CT.aspir.JPG]
Assuming correct positioning, either the pus is too viscous for 18G, or
maybe these are necrotic but not entirely liquid changes.
Will do a lumbar spine MRI tomorrow to check for spondylitis/discitis.
Thanks, and have a lovely afternoon!
Andrei
On Tue, 10 May 2022 at 12:36, Andrei Dumitrescu <xisquare@gmail.com> wrote:
>
> Hi there everyone,
>
> this is a 79 year old lady with bilateral, progressive hip pain
> right>left.
> She has type II diabetes and had an Enterobacter bloodstream Infection 5
> months ago.
>
> MRI shows edema of the iliac muscles right>left, as well as liquid changes
> along both iliopsoas tendons, with peripheral contrast uptake.
> To me these look like possible abscesses. What is your impression? Would
> they be related to the bloodstream Infection?
>
> Surgeons are asking for percutaneous drainage or at least that I take a
> sample. Good idea? Should I do it?
>
> I’m attaching a few screenshots for a quick look, as well as a PPT with
> more images.
>
> Cheers,
>
> Andrei
>
>
>
