Musculoskeletal Hydatid Disease

ABSTRACT

Hydatid disease is an infectious disease caused by the larval stage of the parasitic tapeworm Echinococcosis granulosus. Its distribution is worldwide. Although hydatid disease can develop in almost any part of the body, it is most commonly found in the liver and lung. Musculoskeletal involvement is rare. The radiological appearance of the hydatid disease of musculoskeletal system mimics tumors and other inflammatory conditions. Therefore preoperative diagnosis of musculoskeletal hydatid disease is sometimes difficult clinically and radiologically. On radiography, different radiographic changes may occur. In cases of osteolytic and inflammatory changes, it may mimic any variant of nonspecific or specific osteomyelitis. Bone erosion and destruction may lead to almost complete osteolysis, bone may distort, and on occasion, its radiologic appearances may be confused with those of a malignant bone tumor. Computed tomography (CT) is more accurate in delineating the area of destruction. The primary role of CT and magnetic resonance imaging is in the recognition of extraosseous spread of the hydatid disease within the soft tissues. This article reviews the pathological basis and the clinical and imaging features of musculoskeletal hydatid disease.

KEYWORDS

Echinococcosis granulosus - hydatid disease - hydatidosis - parasitic infection - spinal hydatid disease - tapeworm infestation

REFERENCES

• 1 Kireşi D A, Karabacakoğlu A, Odev K, Karaköse S. Uncommon locations of hydatid cysts.  Acta Radiol. 2003;  44 (6) 622-636
• 2 Memis A, Arkun R, Bilgen I, Ustun E E. Primary soft tissue hydatid disease: report of two cases with MRI characteristics.  Eur Radiol. 1999;  9 (6) 1101-1103
• 3 Comert R B, Aydingoz U, Ucaner A, Arikan M. Water-lily sign on MR imaging of primary intramuscular hydatidosis of sartorius muscle.  Skeletal Radiol. 2003;  32 (7) 420-423
• 4 Polat P, Kantarcı M, Alper F, Suma S, Koruyucu M B, Okur A. Hydatid disease from head to toe.  Radiographics. 2003;  23 (2) 475-494 quiz 536-537
• 5 Tarhan N C, Tuncay I C, Barutcu O, Demirors H, Agildere A M. Unusual presentation of an infected primary hydatid cyst of biceps femoris muscle.  Skeletal Radiol. 2002;  31 (10) 608-611
• 6 Loudiye H, Aktaou S, Hassikou H et al.. Hydatid disease of bone. Review of 11 cases.  Joint Bone Spine. 2003;  70 (5) 352-355
• 7 García-Díez A I, Ros Mendoza L H, Villacampa V M, Cózar M, Fuertes M I. MRI evaluation of soft tissue hydatid disease.  Eur Radiol. 2000;  10 (3) 462-466
• 8 Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa C S. Hydatid disease: radiologic and pathologic features and complications.  Radiographics. 2000;  20 (3) 795-817
• 9 Beggs I. The radiology of hydatid disease.  AJR Am J Roentgenol. 1985;  145 (3) 639-648
• 10 Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern.  Clin Microbiol Rev. 2004;  17 (1) 107-135
• 11 Poyanli A, Akan K, Poyanli O, Sencer S, Sayrak H. Primary hydatid disease of the femur: unsuspected and incidental MRI findings with long-term curative results on medical treatment alone.  Skeletal Radiol. 2001;  30 (11) 656-658
• 12 Morris B S, Madiwale C V, Garg A, Chavhan G B. Hydatid disease of bone: a mimic of other skeletal pathologies.  Australas Radiol. 2002;  46 (4) 431-434
• 13 Resnick D, Niwayama G. Infectious diseases. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders. Philadelphia, PA: WB Saunders; 1988: 2647-2754
• 14 Engin G, Acunaş B, Rozanes I, Acunaş G. Hydatid disease with unusual localization.  Eur Radiol. 2000;  10 (12) 1904-1912
• 15 Oğüt A G, Kanberoğlu K, Altuğ A, Cokyüksel O. CT and MRI in hydatid disease of cervical vertebrae.  Neuroradiology. 1992;  34 (5) 430-432
• 16 Gossios K J, Kontoyiannis D S, Dascalogiannaki M, Gourtsoyiannis N C. Uncommon locations of hydatid disease: CT appearances.  Eur Radiol. 1997;  7 (8) 1303-1308