Treatment and diagnosis of bone hydatid disease / 中华骨科杂志

ABSTRACT

Objective To analyze the diagnosis and treatment of bone hydatid disease retrospectively. Methods From October 1957 to February 2004, thirty-seven consecutive cases, which were 16 males and 21 females, underwent debridement operation. The average age was 29 years ranging from 14 to 58 years. The history of bone hydatid disease was 3.1 years ranging from 0.5 to 12 years. The lesion was located at cervical vetebrae in 2, scapula in 1, thoracic vetebrae in 11, rib in 2, lumbar vetebrae in 5, ilium in 1, sacrum in 1, pelvic pubis in 1, hip joint in 2, femoral intertrochanter in 1, proximal humerus in 2, proximal tibia in 1, humeral head in 1, and proximal rudius in 1. The lesions of all cases were performed curettage thoroughly accepted and some of them received autogenetic or allogenetic bone graft, and artificial bone or bone cement was used to fill the defect in a few cases. Albendazole was used to prevent relapse for 3 months after operation, the dose of Albendazole tablets or powder was 20 mg/kg per day, or liposomal Albendazole 10 mg/kg per day. Results 24 cases were followed up; the period was 2 to 20 years with an average of 3.6 years. Of 37 cases, 31 were hydatid disease of trunk bone (83.78%), 24 were spinal hydatid disease. 25 of 37 cases were performed Casoni test, 21 cases were positive(84%). Four cases accepted the 8-tests immunodiagnosis for human hydatidosis, all were positive. MRI examination was taken in 21 of 37 cases, 18 cases were diagnosed as bone hydatid disease. In 24 cases which were followed up, 11 cases relapsed(45.83%). Conclusion Bone hydatid disease often occurs in the bone of trunk, especially in spine; the X-ray or CT images of bone hydatid disease are similar to tuberculosis, metastases, giant cell tumor, or cyst of bone, it should be identified with these diseases; MRI is valuable to diagnosis of spinal hydatid disease; serological examinations are the major method of identification diagnosis; spinal hydatid disease can not be eliminated easily by operation, and often relapses.