A 35-year-old teacher presents with a painless swelling in the left groin fluctuating but without local heat or redness. Chest X-ray shows bilateral upper lobe infiltrates. Spinal X-ray shows disc space narrowing at L2–L3. The swelling most likely represents:

• A Inguinal lymphadenopathy from groin infection
• B Psoas haematoma from lumbar muscle tear
• C Psoas cold abscess tracking from vertebral TB ✓
• D Femoral hernia with omentum contents

Explanation

A cold abscess from lumbar Pott's disease tracks along the psoas sheath and presents in the groin below the inguinal ligament as a fluctuant swelling without inflammatory signs — hence 'cold.' The combination of a painless groin swelling, vertebral disc destruction at the lumbar level, and radiological evidence of pulmonary tuberculosis strongly supports a psoas abscess. The abscess can also track to the gluteal region or the back.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.