The psoas fascia encloses the psoas major and minor muscles, forming the posterior wall of the retroperitoneal compartment. It attaches medially to the lumbar vertebral bodies and transverse processes, laterally blending with the quadratus lumborum fascia, and inferiorly continuing as the iliac fascia as the muscle crosses the pelvic brim.
The psoas fascial compartment determines the spread of psoas abscess, which tracks within this fascia to present in the iliac fossa or femoral triangle. A psoas haematoma in anticoagulated patients or after lumbar surgery expands within the fascia, compressing the femoral nerve. The fascial compartment is the route for retroperitoneal haematoma propagation in lumbar artery injury.
Retroperitoneal bleeding contained within the psoas fascia from anticoagulation or lumbar trauma, producing anterior thigh numbness from femoral nerve compression and a palpable flank mass.
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