Musculoskeletal hydatid infections are a very rare form of hydatid disease.
For a general discussion, and for links to other system-specific manifestations, please refer to the article on hydatid disease.
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Clinical presentation
Patients usually present with slow-growing swelling with or without pain.
Pathology
Location
They can present almost anywhere, but the most common locations are:
vertebrae (see spinal hydatid disease) and paravertebral soft tissues
pelvis
femur and soft tissue of the lower limbs
tibia
Radiographic features
Plain radiograph
may show expansile lytic lesion in the involved bone which can be unilocular or multilocular with coarse trabeculae
thinning of cortex
adjacent soft tissue swelling may be seen due to direct extension from the bone or co-existing multiple soft tissue lesions
Ultrasound
Ultrasound may depict lesions in the soft tissue which can be solitary/multiple unilocular/multilocular/complex cystic lesions and/or atypical solid hypoechoic lesions.
CT
Better delineates expansile unilocular or multilocular lytic lesion and demonstrates any soft tissue extension. Co-existing soft tissue multilocular cysts may be seen.
MRI
-
T1: hypointense cyst
may show low-intensity rim
T1 C+: shows wall enhancement
-
T2: hyperintense cyst (uni/multilocular) with a low-intensity rim
water lily sign may be seen
Differential diagnosis
soft tissue tumor (benign/malignant)
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