[Limp as a presenting symptom of psoas muscle inflammation].

Inflammatory irritation of the psoas muscle in children is rare. The initial diagnosis may be difficult because of the similarity between the symptoms of psoas muscle inflammation and septic hip joint. We present a boy and a girl, both 3.5 years old, with psoas muscle inflammation, whose initial clinical and laboratory findings could be explained by either septic hip joint or osteomyelitis. Both presented with fever and limp. 1 developed an acute abdomen within 3 days and at operation a retrocecal periappendicular abscess was found. In the other, left lower quadrant, abdominal pain developed 4 days following admission and ultrasonic findings indicated a left psoas muscle abscess. We suggest that psoas muscle inflammation should be added to the differential diagnosis of limp in children. Early correct diagnosis can be established by proper physical examination, including rectal examination, and with the aid of diagnostic tools such as ultrasound, computerized tomography or both.