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Laasri K, Naggar A, Bahlouli N, Chait F, Ahallat I, Boufettal M, Bassir RA, Mekkaoui J, Kharmaz M, Omar lamrani M, Berrada MS, zouaidia F, El aoufir O, Laamrani FZ, Jroundi L. Osseous hydatid disease: A mimic of other skeletal pathologies. Radiol Case Rep 2023; 18:3145-3151. [PMID: 37409101 PMCID: PMC10318460 DOI: 10.1016/j.radcr.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023] Open
Abstract
Hydatid disease is still endemic in several regions worldwide including Morocco, and is caused in most cases by the larval form of 2 species of the tapeworm Echinococcus: E. granulosus and E. multilocularis. Primary hydatid disease of the bone without systemic involvement is rare. The disease has a silent clinical evolution until it reaches complicated stages. Complications may include pathological fracture, neural deficit, infection, and fistulization of the abscess. Preoperative diagnosis is based on clinical history, imaging findings, and serological tests, which lack high sensitivity and specificity. Although the interpretation of imaging studies can prove to be very confusing because the bone changes evolve with time, and the nonspecificity of these findings often leads to a mistaken diagnosis. The diagnosis requires a high index of suspicion, especially in patients who reside in or travel to sheep-raising areas where hydatid disease is endemic. A high index of suspicion is necessary for the diagnosis, especially in patients that live in or travel to sheep-raising areas where hydatid disease is endemic. The treatment of choice remains surgical, following the principles of a locally malignant lesion. Chemotherapy (albendazole alone or in combination with praziquantel) is indicated when surgery is not possible or as an adjuvant treatment. The prognosis is often poor. We report the case of a 28-year-old woman with long-standing pain in the left hip joint in which the imaging findings were thought of as being either tuberculous or neoplastic. The result of a CT-guided biopsy concurred with an unexpected diagnosis of a hydatid cyst. This case highlights that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in the bone to those of other skeletal pathologies can lead to misinterpretation.
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Affiliation(s)
- Khadija Laasri
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Amine Naggar
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Nourrelhouda Bahlouli
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Fatima Chait
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Ilyass Ahallat
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Moncef Boufettal
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Reda Allah Bassir
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Jalal Mekkaoui
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Kharmaz
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Moulay Omar lamrani
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Saleh Berrada
- Department of Orthopedics and Traumatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Fouad zouaidia
- Department of Anatomo-Patholgy, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Omar El aoufir
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Fatima Zahra Laamrani
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Laila Jroundi
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
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Johny J, Andrew D, Shyam K. Multimodality imaging in a patient with hydatid disease of the pelvic bone. BMJ Case Rep 2020; 13:e237830. [PMID: 33127707 PMCID: PMC7604880 DOI: 10.1136/bcr-2020-237830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Jovis Johny
- Radiology, St Johns Medical College and Hospital, Bangalore, Karnataka, India
| | - Dhilip Andrew
- Radiology, St Johns Medical College and Hospital, Bangalore, Karnataka, India
| | - Karthik Shyam
- Radiology, St Johns Medical College and Hospital, Bangalore, Karnataka, India
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Successful Pelvic Resection for Acetabular Hydatidosis. Case Rep Orthop 2017; 2017:9495783. [PMID: 29130011 PMCID: PMC5654322 DOI: 10.1155/2017/9495783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 08/30/2017] [Indexed: 11/18/2022] Open
Abstract
Background Hydatidosis of the bone is a rare occurrence (0.9 to 2.5% of all localization of the disease). In those occurrences, the pelvic bone is the second most frequent localization. Curative treatment of pelvic bone hydatidosis is difficult and a consensus is yet to be found. Clinical Case We report a case of hydatidosis of the ischium, extended to the homolateral hip. The patient was treated through hip resection using patient-specific cutting guides, followed by total hip reconstruction. Albendazole was administered to the patient for two months before the surgery and for three months following the surgery. Conclusions In a young patient, hydatidosis of the pelvic bone can be treated with satisfying results through wide resection of the hip coupled with an antiparasitic treatment administered before and after the surgery. Prosthetic reconstruction, similar to what is done in cancer surgery, restores good functions.
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Nhamoucha Y, Alaoui O, Doumbia A, Oukhoya M, Abdellaoui H, Tazi M, Chater L, Atarraf K, Arroud M, Afifi A. [Bone hydatid cyst: a rare localization at the level of the hip bone]. Pan Afr Med J 2016; 24:226. [PMID: 27800081 PMCID: PMC5075477 DOI: 10.11604/pamj.2016.24.226.6322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 02/21/2015] [Indexed: 11/11/2022] Open
Abstract
Hydatid disease is a parasitic disease caused by the development in humans of the larval form of a tapeworm, namely a very small tænia called Echinococcus Granulosus. This anthropozoonosis is characterized by the presence of different types of anatomo-radiologic variants associated with various topographic and evolutionary aspects of the cysts. Bone hydatid disease is a rare condition, it accounts for only 0.9-2.5% of all locations. We report the case of a 9 year old child, who was admitted with febrile lameness and with a mass in the right iliac fossa, revealing a hydatid cyst at the level of the hip bone. Lesion assessment objectified a hydatid cyst of the hip bone with extension into adjacent soft tissues. An infected cyst was detected during surgery, hence the performance of a surgical excision of the cyst with drainage. Hydatic osteopathy is infiltrating, diffuse, slow and gradual, causing delays in diagnosis and compromising the quality of care.
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Affiliation(s)
- Yassine Nhamoucha
- Service de Traumato-Orthopédie Pédiatrique, Hôpital Mère et Enfant, CHU de Fès, Maroc
| | - Othmane Alaoui
- Service de Chirurgie Pédiatrique, CHU Hassan II, Fès, Maroc
| | - Aliou Doumbia
- Service de Chirurgie Pédiatrique, CHU Hassan II, Fès, Maroc
| | | | | | - Mohammed Tazi
- Service de Chirurgie Pédiatrique, CHU Hassan II, Fès, Maroc
| | - Lamyae Chater
- Service de Chirurgie Pédiatrique, CHU Hassan II, Fès, Maroc
| | - Karima Atarraf
- Service de Chirurgie Pédiatrique, CHU Hassan II, Fès, Maroc
| | - Mounir Arroud
- Service de Chirurgie Pédiatrique, CHU Hassan II, Fès, Maroc
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Csotye J, Sisák K, Bardócz L, Tóth K. Pathological femoral neck fracture caused by an echinococcus cyst of the vastus lateralis--case report. BMC Infect Dis 2011; 11:103. [PMID: 21510859 PMCID: PMC3095994 DOI: 10.1186/1471-2334-11-103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 04/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal hydatid cysts are rare, but being locally invasive, can potentially cause significant deformity or pathological fracture. CASE PRESENTATION A 39 y.o. male presented to our orthopaedic outpatient clinic complaining of severe right hip pain, and inability to ambulate. Symptoms were not preceded by trauma. Subsequent imaging confirmed a large, 17 × 3 × 5 cm echinococcus cyst in the vastus lateralis, causing erosion of the proximal metaphysis of the femur. As a consequence the patient suffered a non-traumatic pathological intertrochanteric femur fracture. The patient was treated with an en-bloc excision of the lesion - the affected soft tissue envelope containing the large cyst - and as a second surgical step a cemented total hip replacement (THR) was implanted under the same anaesthetic. The manuscript reviews the literature regarding musculoskeletal hydatid disease.
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Affiliation(s)
- János Csotye
- 1Department of Traumatology, Békés County Hospital, 1 Semmelweis Street, Gyula, 5700, Hungary
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Gdoura F, Trigui M, Zribi W, Ellouze Z, Bouzidi R, Ayedi K, Keskes H. Pelvic bone hydatidosis. ORTHOPAEDICS & TRAUMATOLOGY, SURGERY & RESEARCH : OTSR 2010; 96:85-9. [PMID: 20170864 DOI: 10.1016/j.rcot.2009.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Accepted: 04/08/2009] [Indexed: 02/02/2023]
Abstract
Bone hydatid disease is a rare pathology, characterized by its long clinical latency, the absence of radiological specificity as well as its challenging surgical treatment. We report an observation of pelvic bone hydatidosis in a 28-year-old patient, appearing with pain and stiffness of the hip as well as a degenerative aspect on the coxofemoral joint on X-ray. The treatment consisted of an extensive hemipelvectomy with femoro pelvic arthrodesis, completed by medical treatment. The functional result was excellent in spite of a break in the fixation material, which allowed a certain mobility at the proximal end of the femur. Hydatid disease of bone is infiltrating,diffuse, slow, and progressive, all characteristics explaining the often-delayed diagnosis. Medical imaging provides accurate analysis for planning a broad surgical resection. The quality of surgical resection is determined according to the risk of recurrence. Pelvic locations are particularly difficult to treat. After an enlarged and difficult surgical resection, reconstruction remains aleatory and poses many technical problems.
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Affiliation(s)
- F Gdoura
- Service de chirurgie orthopédique et traumatologique, faculté de médecine de Sfax, CHU Habib Bourguiba, route El-Aïn Km 0,5 CP, 3029 Sfax, Tunisie
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Nieto JM, Vives I, Jiménez JA, González MA, Guerrero E, Roigé J. [Anesthetic management of sacroiliac-vertebral echinococcosis]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2008; 55:434-437. [PMID: 18853682 DOI: 10.1016/s0034-9356(08)70615-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Bone echinococcosis affects the spine and pelvis in 60% of cases. Bone lesions may be silent for between 10 and 20 years. The capsules progress aggressively through the medullary canal and replace the trabecular bone without forming cysts, as occurs in the organs, thus making anaplylaxis rare. The combination of chemotherapy and surgery facilitates anesthetic management and reduces the incidence of anaphylactic events and disease recurrence.
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Affiliation(s)
- J M Nieto
- Departamento de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Vail d'Hebron, Barcelona.
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