musculoskeletal hydatid infection

Musculoskeletal hydatid infections are a very rare form of hydatid disease.

For a general discussion, and for links to other system-specific manifestations, please refer to the article on hydatid disease.

Clinical presentation

Patients usually present with slow-growing swelling with or without pain.

Pathology

Location

They can present almost anywhere, but most common locations are:

• vertebrae (see spinal hydatid disease) and para-vertebral soft tissue
• pelvis
• femur and soft tissue of lower limb
• tibia

Radiographic features

Plain radiograph

• may show expansile lytic lesion in the involved bone which can be unilocular or multilocular with coarse trabeculae
• thinning of cortex
• adjacent soft tissue swelling may be seen due to direct extension from the bone or co-existing multiple soft tissue lesions

Ultrasound

Ultrasound may depict lesions in the soft tissue which can be solitary/multiple unilocular/multilocular/complex cystic lesions and/or atypical solid hypoechoic lesion.

CT

Better delineates expansile unilocular or multilocular lytic lesion and demonstrates any soft tissue extension. Co-existing soft tissue multilocular cysts may be seen.

MRI

• T1: hypointense cyst
  • may show low-intensity rim
• T1 C+: shows wall enhancement
• T2: hyperintense cyst (uni/multilocular) with a low-intensity rim
  • water lilly sign may be seen

Differential diagnosis

• osteomyelitis
• lytic bone lesions
• tuberculous spondylitis
• abscess
• soft tissue tumor (benign/malignant)

Siehe auch:

• Osteomyelitis
• Abszess
• Echinokokkose
• Echinococcus multilocularis
• muskuloskelettale Tuberkulose
• Weichteiltumoren

und weiter:

• hydatid disease with thyroid, abdominal wall and kidney involvement
• hydatid disease with hepatic, osseous and muscular involvement
• Alveoläre Echinokokkose
• hydatid disease with muscular involvement
• spinale Echinokokkose
• primäre Hydatidzyste der Muskulatur