A cold abscess from Pott's spine at L1–L2 level typically tracks along which muscle and presents as a swelling at which site?

• A Quadratus lumborum muscle; presents in the flank
• B Psoas major muscle; presents below the inguinal ligament in the femoral triangle ✓
• C Piriformis muscle; presents in the buttock
• D Gluteus maximus muscle; presents as a gluteal swelling

Explanation

Pus from lumbar Pott's spine tracks along the psoas major muscle (which originates from the lumbar vertebral bodies and transverse processes) within the psoas sheath and descends below the inguinal ligament to present as a fluctuant swelling in the femoral triangle — a 'cold abscess' or 'psoas abscess.' It can also present along the iliacus beneath the inguinal ligament or on the inner aspect of the thigh. Cervical Pott's abscess presents retropharyngeally; thoracic abscess forms a paravertebral fusiform shadow on X-ray. Recognizing the tracking pattern is classic in NEET PG.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.