Images in Clinical Medicine
Psoas Hematoma
N Engl J Med 2001; 344:349February 1, 2001
- Article
Figure 1 An 83-year-old woman who was taking acenocoumarol because of a previous pulmonary embolism presented with tiredness, a limp, and extensive bruising of both legs. Two weeks earlier, she had had multiple hematomas of the legs, which had been attributed to overanticoagulation. The dose of acenocoumarol was subsequently reduced. Examination revealed spontaneous flexion of the right hip, with tenderness elicited by stretching of the psoas muscle by extension of the hip — the psoas sign. The hemoglobin level was 9.3 g per deciliter, the platelet count was normal, and the prothrombin time was markedly prolonged (international normalized ratio, >7). A computed tomographic scan obtained without the administration of contrast medium revealed enlargement and heterogeneity of the right iliopsoas muscle (arrow), a finding consistent with the presence of a large hematoma. Treatment with acenocoumarol was stopped, and fresh plasma was infused. The patient recovered completely within one week and remained well one year later.
Charles Cuvelier, M.D.
Clinique Sainte Elisabeth, 5000 Namur, Belgium- Citing Articles (1)
Citing Articles
1
S PARMER, J CARPENTER, R FAIRMAN, O VELAZQUEZ, M MITCHELL. (2006) Femoral Neuropathy following Retroperitoneal Hemorrhage: Case Series and Review of the Literature. Annals of Vascular Surgery 20:4, 536-540
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