Case Report An Easily Overlooked Presentation of Malignant Psoas Abscess: Hip Pain Ayhan Askin, 1 Korhan Baris Bayram, 1 Umit Secil Demirdal, 1 Merve Bergin Korkmaz, 1 Alev Demirbilek Gurgan, 1 and Mehmet Fatih Inci 2 1 Katip Celebi University, Ataturk Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, 35360 Izmir, Turkey 2 Katip Celebi University, Ataturk Training and Research Hospital, Radiology Clinic, 35360 Izmir, Turkey Correspondence should be addressed to Ayhan Askin; ayhanaskin@hotmail.com Received 20 October 2014; Accepted 7 January 2015 Academic Editor: Athanassios Papanikolaou Copyright © 2015 Ayhan Askin et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Psoas abscess is a rare infectious disease with nonspecifc clinical presentation that frequently causes a diagnostic difculty. Its insidious onset and occult characteristics can cause diagnostic delays. It is classifed as primary or secondary. Staphylococcus aureus is the most commonly causative pathogen in primary psoas abscess. Secondary psoas abscess usually occurs as a result of underlying diseases. A high index of clinical suspicion, the past and recent history of the patient, and imaging studies can be helpful in diagnosing the disease. Te delay of the treatment is related with high morbidity and mortality rates. In this paper, 54-year-old patient with severe hip pain having an abscess in the psoas muscle due to metastatic cervical carcinoma is presented. 1. Introduction Psoas abscess (PA) is a rarely observed infective clinical con- dition, which is difcult to diagnose and therefore may cause morbidity and mortality [1]. Psoas muscle is located in retroperitoneal space and extends from lateral borders of 12th thoracic vertebra and all lumbar vertebra to femur trochanter minor. It is closely adjacent to organs such as kidneys, sigmoid colon, jejunum, appendix, pancreas, abdominal aorta, and ureter [2]. Due to anatomic localization and signifcant adjacency of the muscle, PA may demonstrate a variable clinical symptomatology and may have an insidious course, and there may be treatment challenges when diagnosed [2, 3]. Te classical clinical presentation of the disease is fever, back pain, and walking abnormality (limping) [3]. Tere are numerous reports related to PA in the literature [4–6]. How- ever, patients applying with subacute hip pain and walking abnormality are rather rarely observed by physicians engaged in musculoskeletal system. Herein a patient who had abscess which developed in psoas muscle secondary to multiple metastasis of cervical carcinoma and who applied to our outpatient clinic with complaint of hip pain was presented. 2. Case Report A 54-year-old female patient was admitted to our outpatient clinic with complaints of lef hip pain markedly increasing for 10 days and difculty in walking. She stated that she had hip pain for about 2 months, and she was treated by many physi- cians. Patient had difculty in load transfer during walking and therefore had ambulation difculty. She defned loss of appetite and sometimes fever. She did not defne low back pain, radicular symptoms, neuropathic complaints, trauma, rash, aphtha, diarrhea, arthritis, abdominal pain, a recent infection, a history of intramuscular injection, weight loss, history of eating fresh cheese, and history of tuberculosis. Patient received chemotherapy and radiotherapy 3 years ago due to cervical cancer, and she was a diabetes patient using insulin. In patient’s evaluation, her arterial blood pressure mea- surement was 110/70mmHg, her fever was 37.1 ∘ C, and her pulse rate was 95/minute. Patient appeared to be pale and tired, and she was mobilized on wheelchair. Due to pain, she could not bear load on lef lower extremity, she needed assis- tance in walking, and she had difculty in transfer activities. Hindawi Publishing Corporation Case Reports in Orthopedics Volume 2015, Article ID 410872, 4 pages http://dx.doi.org/10.1155/2015/410872