The value of computed tomography in osseous hydatid disease (echinococcosis)

Primary hydatid cyst of the root of the thigh: a case report and review of the literature

Hydatid disease of bone is a rare event, and it is characterized by a high diagnostic and therapeutic complexity. We report a case of primary hydatidosis of the proximal thigh involving both the soft tissues and the proximal femur in a 59-year-old man. It has been possible to establish the diagnosis only 8 years after the appearance of the first symptoms (painful swelling over the root of the left thigh), when the patient came to our institution after several investigations.

Echinococcosis granulosus/cysticus of the tibia

Hydatid disease is caused by the parasitic tapeworm Echinococcus. There are three species: E. granulosus, E. alveolaris and E. voegeli. Only E. alveolaris and E. granulosus are important for human infections. These two species are totally divergent in their manner of infestation. Hydatid disease is a rare parasitic disease that primary involves the liver and the lung. Skeletal disease is rare, accounting for less than 2% of all hydatid lesions, and often presents as a clinical and radiologic diagnostic problem. The skeletal involvement is usually due to secondary extension after haematogenous spread of the infection. The vertebral column, the pelvis and the skull are most commonly involved. Treatment is also difficult because of the invasive nature of bony involvement and the spillage of fluid with subsequent contamination seeding. We present a case of primary hyatid cyst of the tibia. We point out the importance of considering osseous hydatidosis in the differential diagnosis of destructive bone lesions and the necessity of radical resection.

Hydatid disease of bones and joints. 8 cases followed for 4-16 years

Hydatid disease is a rare parasitic disease that seldom involves the skeleton. Treatment is difficult because of problems with the preoperative diagnosis, the invasive nature of the bony involvement and the variable anaphylactic reaction to the cyst fluid antigen. We present 8 cases with osseous hydatidosis who were treated over a period of 11 years. The spine was involved in 2 cases, the ilium in 2, the hip in 2, the tibia in 1 and the humerus in 1. We point out that diagnosis is difficult and the prognosis is often poor.

Sacrococcygeal hydatid cyst: another entity in the differential diagnosis of sacrococcygeal chordoma. Case report

A case of hydatid disease of the sacrum with severe neurological symptoms, which was misdiagnosed preoperatively as a chordoma, is presented. The patient had significant improvement of the neurological symptoms after evacuation of the cyst. Sacral hydatid cysts must be considered in the differential diagnosis of sacrococcygeal chordoma.

The value of plain film findings in hydatid disease of bone

The radiographic features of hydatid disease of bone have been reviewed in 16 Kuwaiti patients. The majority of the lesions were in the lower limb or pelvis, and the commonest presentation was with a pathological fracture. The radiological signs seen most often were lucent lesions in the bone, associated with expansion of the bone and thinning of the cortex. In patients with these signs soft tissue calcification appeared to be highly suggestive of hydatid disease. The disease was diagnosed before operation in only half the patients. In areas where the disease is endemic hydatid disease should be suspected when the lesions described are seen on plain films.

CT and MRI in hydatid disease of cervical vertebrae

Hydatid disease (HD) of the cervical spine is rare. A case investigated by computed tomography (CT) and magnetic resonance imaging (MRI) is presented. While CT shows the bone lesion better, MRI is superior in demonstrating compression of neural structures. The complementary use of CT and MRI in such cases is suggested.

Radiographic and computed tomographic findings in hydatid disease of bone

Twenty-six patients with hydatid disease of bone were evaluated by means of radiography and conventional tomography. Fourteen patients underwent high resolution computed tomography (CT). In two patients with vertebral disease, magnetic resonance imaging (MRI) examination was also performed. Seventeen patients underwent surgery with histological examination in all. Based on the surgical data and gross examination of the specimen, the radiographic and CT findings have been reviewed to identify the most characteristic radiographic features and to assess the role of CT. Radiographic finding of hydatidosis are rarely typical in bone, and only in a few patients can CT contribute to the diagnosis. On the other hand, the local extension of the lesion both in bone and in soft tissues, which is essential in planning surgery, is always demonstrated well by CT.