Iliopsoas abscess

This chapter examines iliopsoas abscess (IPA), which is a rare condition defined by a collection of purulence in the iliopsoas muscle compartment. IPA is classified in two distinct varieties based upon the etiology of the disease. IPA can be either primary wherein the infection spreads via a hematogenous or lymphatic route, or secondary when it is a contiguous extension of another infection—most often musculoskeletal, intraabdominal, or genitourinary. Symptoms can consist of a classic triad of back/flank pain, fever, and a limp on ambulation (flexion deformity), however all three are rarely present and more generalized symptoms of malaise and weight loss may be present. The common presentation with more vague and general symptoms often leads to a delay in diagnosis and treatment that significantly worsens associated morbidity and mortality. Early and effective management is key to a successful recovery.