Abstract

Case: A 52-year-old diabetic woman presented with progressive low back pain and left lower extremity weakness, which started two weeks after receiving a steroid injection into the greater trochanteric bursa. Magnetic resonance image (MRI) lumbar spine demonstrated left L4-L5 facet joint involvement. Her hospital course was significant for a large left iliopsoas abscess, left knee prosthetic joint infection, a small epidural abscess and sepsis. Patient underwent multiple debridement of the paraspinal and pelvic iliopsoas abscess with wound vacuum exchanges and a staged revision knee arthroplasty. At the last follow up 6 months after initial presentation, the low back pain and left hip flexor weakness improved, the lumbar spine and pelvic wounds healed and was awaiting second stage left knee revision.
Conclusion: To the authors best knowledge, this is the first report in the literature of a psoas abscess spreading from a septic facet joint following local greater trochanteric bursa glucocorticoid injection and without an inciting spine corticosteroid injection.