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.
Subject(s)
Echinococcosis/complications , Echinococcosis/surgery , Femoral Neck Fractures/surgery , Fractures, Spontaneous/surgery , Quadriceps Muscle/surgery , Adult , Animals , Arthroplasty, Replacement, Hip/statistics & numerical data , Echinococcosis/parasitology , Echinococcosis/pathology , Echinococcus , Femoral Neck Fractures/etiology , Femoral Neck Fractures/parasitology , Fractures, Spontaneous/etiology , Fractures, Spontaneous/parasitology , Hip Fractures/surgery , Humans , Male , Quadriceps Muscle/parasitology , Quadriceps Muscle/pathologySubject(s)
Bone Diseases, Infectious/parasitology , Echinococcosis/complications , Fractures, Closed/etiology , Fractures, Spontaneous/etiology , Humeral Fractures/etiology , Adolescent , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Bone Diseases, Infectious/diagnosis , Bone Diseases, Infectious/diagnostic imaging , Bone Diseases, Infectious/drug therapy , Bone Diseases, Infectious/pathology , Bone Diseases, Infectious/surgery , Combined Modality Therapy , Curettage , Echinococcosis/diagnosis , Echinococcosis/diagnostic imaging , Echinococcosis/drug therapy , Echinococcosis/pathology , Echinococcosis/surgery , Echinococcosis, Hepatic/complications , Echinococcosis, Hepatic/drug therapy , Female , Fractures, Closed/diagnostic imaging , Fractures, Closed/drug therapy , Fractures, Closed/parasitology , Fractures, Closed/pathology , Fractures, Closed/surgery , Fractures, Spontaneous/diagnostic imaging , Fractures, Spontaneous/drug therapy , Fractures, Spontaneous/parasitology , Fractures, Spontaneous/pathology , Fractures, Spontaneous/surgery , Humans , Humeral Fractures/diagnostic imaging , Humeral Fractures/drug therapy , Humeral Fractures/parasitology , Humeral Fractures/pathology , Humeral Fractures/surgery , Magnetic Resonance Imaging , Radiography , Saline Solution, Hypertonic/administration & dosage , Therapeutic IrrigationABSTRACT
A case of primary hydatid disease of the right femur is reported that presented with pathological fracture and was diagnosed at the time of exploration for biopsy. The patient was treated by removal of all cysts, irrigation with scolicidal solution, bone grafting and immobilisation of the fracture followed by four cycles of oral Albendazole. Eosinophilia and serological tests reverted to normal but the patient died due to acute myocardial infarction six months later. This uncommon condition should be considered in the differential diagnosis of pathological fractures, bone pain or osteolytic lesions, especially in patients of rural and farmer background.
Subject(s)
Echinococcosis/complications , Femoral Fractures/parasitology , Fractures, Spontaneous/parasitology , Administration, Topical , Albendazole/therapeutic use , Anticestodal Agents/therapeutic use , Cetrimonium , Cetrimonium Compounds/therapeutic use , Echinococcosis/therapy , Female , Femoral Fractures/therapy , Fractures, Spontaneous/therapy , Humans , Middle Aged , Orthopedic Procedures/methodsABSTRACT
Magnetic resonance (MR) findings of a rare case of osseous echinococcosis with involvement of the femur are described. Attention is drawn to the typical MR appearances and therapeutic management.
Subject(s)
Bone Diseases/parasitology , Echinococcosis/pathology , Femur/pathology , Magnetic Resonance Imaging , Adult , Bone Diseases/diagnosis , Bone Diseases/surgery , Echinococcosis/surgery , Femur/surgery , Fractures, Spontaneous/diagnosis , Fractures, Spontaneous/parasitology , Fractures, Spontaneous/surgery , Humans , MaleABSTRACT
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.
