Hydatid Disease of The Bone

Ekta Jain,Sudhir Garg,Amrita Bhattacharya,Rajpal S Punia

doi:10.21276/apalm.2596

Abstract

Hydatid disease of the bone is a very rare condition. It represents about 0.5–4% of all human hydatid disease. Spine is the most affected part of the skeleton (50% cases). Extra-spinal bone hydatidosis is much rare. A 20 year old woman presented with severe pain and swelling in left thigh. On examination, there was a boggy swelling in left thigh suggestive of abscess. MRI of left hip joint and thigh revealed features of osteomyelitis with pathological fracture in upper shaft along with multiloculated collections in upper thigh muscle. Biopsy revealed evidence of Hydatid cyst. Hydatid disease of the bone is a rare manifestation of Echinococcosis. It is hence important to consider the possibility of Hydatid disease of the bone as a differential diagnosis of lucent lesions of bone especially in areas where it is prevalent for proper treatment of the patient. Radiological, laboratory, and clinical findings combined with strong element of suspicion are the key for diagnosis.

Highlights

Hydatid disease is caused by the larval stage of the Echinococcus tapeworm
Hydatid disease of the bone is a very rare condition representsing about 0.5–4% of all cases.[2,3]
We report a case of hydatid disease of femur presenting with a hairline fracture complicated by chronic osteomyelitis and sinus formation with multiple recurrences

Summary

Introduction

Hydatid disease is caused by the larval stage of the Echinococcus tapeworm. It can occur almost anywhere in the body with most common sites being liver and lung.[1]. X-Ray and MRI of left hip joint and thigh revealed features of osteomyelitis with extensive cortical and marrow destruction, suggestive of cystic content/abscess formation. It showed a pathological fracture in the sub trochanteric area with lateral displacement of distal femur shaft with contiguous multiloculated collections in upper thigh muscle (Figure 1). The patient underwent diagnostic incisional biopsy which revealed evidence of hydatid disease recurrence She was started Albendazole following which she remained asymptomatic for three months after which she again developed swelling and discharge. C-134 the spread of infection to both hip and knee joints making a radical surgery difficult She was again started Albendazole and kept on immobilization for two months. It revealed persistence of the intramuscular cysts with increase in size

Discussion

Conclusion