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Bone echinococcosis with hip localization: A case report with evaluation of imaging features
Giuseppe Martinese1, Vincenzo Lucidi1, Paola Di Masi1
1Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy.
Radiology Case Reports
|July 25, 2022
Summary
Hydatid disease (HD) can cause rare bone infections, particularly in the pelvis. Early diagnosis and treatment are crucial for managing this parasitic zoonotic disease.
Area of Science:
- Parasitology
- Orthopedic Surgery
- Radiology
Background:
- Hydatid disease (HD) is a zoonotic parasitic infection caused by Echinococcus larvae.
- Bone echinococcosis is a rare manifestation, comprising 0.5%–4% of all HD cases.
Observation:
- A 29-year-old male presented with chronic left hip pain, later diagnosed with pelvic echinococcosis after acetabular fracture.
- Imaging revealed an osteolytic acetabular lesion with cortical disruption, indicative of multiple cysts.
- A CT-guided biopsy confirmed echinococcus cyst, leading to albendazole therapy, cyst exeresis, curettage, and hip arthroplasty.
Findings:
- Despite initial treatment, disease recurrence was observed 22 months post-surgery, with cyst enlargement noted after 4.5 years of chronic therapy.
- A second surgical intervention for cyst exeresis and pelvic bone curettage was performed.
Implications:
- This case highlights the importance of considering hydatid cysts in the differential diagnosis of non-specific pelvic pain, especially in endemic regions.
- Recurrence underscores the need for long-term monitoring and potentially chronic management strategies for bone echinococcosis.
