case_images: PMC11723724_01
case_images: Radiography, computed tomography scanning, and magnetic resonance imaging at initial examination. Anteroposterior (A) and lateral (B) radiographs of the lumbar spine, coronal [C], and axial (D) contrast-enhanced computed tomography images, T1-weighted images magnetic resonance imaging. (E, F, G, H) There were no signs of an epidural abscess or facet infection. (G) The arrowhead indicates a psoas major muscle abscess.
case_images: JOCR-15-150-g001.jpg
case_images: PMC11723724_01_JOCR-15-150-g001.jpg
case_images: F1
case_images: Plain lumbar radiographs revealed sciatic scoliosis on the right side and contrast-enhanced computed tomography (CT) revealed a low-absorption area with rim enhancement in the right paraspinal muscle (Fig. 1a, b, c, d). T1-weighted images compared with the muscle intensity, with rim enhancement extending into the right psoas major muscle through the interspaces of the costal processes at the L1/2 level. There were no signs of an epidural abscess or facet infection (Fig. 1e, f, g, h).
case_images: Ultrasound-guided puncture of the intra/paraspinal muscle of the lesion (A) and bloody viscous fluid (B). The two arrows indicate the needle and the dotted arrows indicate the fluid in the paraspinal muscle.
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case_images: PMC11723724_01_JOCR-15-150-g002.jpg
case_images: F2
case_images: Ltd., Tokyo, Japan) (Fig. 2a). Approximately 18 mL of bloody viscous fluid (Fig. 2b) was aspirated and MRSA was detected using a culture test.
case_images: (A, B, C, D) Magnetic resonance imaging after the initial ultrasound-guided puncture (E) and bloody viscous aspirate, similar to the first aspirate, at the second puncture.
case_images: JOCR-15-150-g003.jpg
case_images: PMC11723724_01_JOCR-15-150-g003.jpg
case_images: F3
case_images: CRP levels decreased over time, and MRI revealed that the abscess had markedly decreased in size (Fig. 3a, b, c, d). Additional percutaneous aspiration was performed using an 18G needle, and approximately 8 mL of bloody viscous fluid (Fig. 3e) was aspirated; the culture was negative.
case_images: (A, B, C) T2-weighted magnetic resonance imaging at the final follow-up revealed that the abscess had decreased markedly in size.
case_images: JOCR-15-150-g004.jpg
case_images: PMC11723724_01_JOCR-15-150-g004.jpg
case_images: F4
case_images: The CRP test results were negative, and MRI revealed a prominent reduction in abscess size with no symptom recurrence (Figs. 4a, b, c and 5).
case_images: Time course after admission. The C-reactive protein and white blood cell counts gradually decreased and turned negative. The right low back pain disappeared, and fever decreased the day after puncture.
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case_images: PMC11723724_01_JOCR-15-150-g005.jpg
case_images: F5
case_images: The CRP test results were negative, and MRI revealed a prominent reduction in abscess size with no symptom recurrence (Figs. 4a, b, c and 5).