An Uncommon Muscle Abscess in the Elderly

1873-9598/$ – see front matter Copyright 2011, Taiwan Society of Geriatric Emergenc doi:10.1016/j.ijge.2011.01.015 quadrant pain for 5 days. Computed tomography revealed osteomyelitis in the right pubic bone. A poor response to antimicrobial therapy and progressive pain and limp were noted. Gallium scintigraphy revealed incongruent uptake in the right groin region and peripheral soft tissue (Fig. 1A, arrow). Axial plane fat-suppressed T1-weighted postcontrast magnetic resonance imaging revealed hyperintense areas to the right of the pubic symphysis, right obturator internus, right obturator externus, right adductor brevis, and right pectineus muscles, characteristic of infectious myositis and osteomyelitis (Fig. 1B, arrow). Furthermore, an abscess (4 2 cm) was noted in the obturator internus muscle (Fig. 1B, arrowhead). After successful computed tomography–guided aspiration and antimicrobial therapy, fever subsided and symptoms were alleviated. Although obturator internus muscle abscess primarily affects children and adolescents, it should be considered in differential diagnosis for all age groups.