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Psoas abscess revealed by gallium SPECT/CT.

Psoas abscess is an uncommon condition that can be easily misdiagnosed if planar scintigraphy alone is used. Single photon emission computed tomography (SPECT)/CT is superior to planar imaging because it can usually eliminate the problem of misdiagnosis. We describe a case of a 70-year-old woman with intermittent pyrexia and gradual onset of left hip pain for 2 days. Planar scintigraphy with technetium-99m methylene diphosphonate and gallium-67 citrate revealed radiotracer accumulation on the left side of the vertebral column at the L4–L5 level and the left sacroiliac joint. SPECT/CT scan revealed gallium-67 accumulation not only in the aforementioned osteomyelitic regions but also in the left psoas muscle, which was finally identified as a psoas abscess. The spatial and anatomic information provided by SPECT/CT, which helped identify the occult infection, was more accurate than that by conventional planar imaging modalities.