Musculoskeletal hydatid infection

Last revised by Vikas Shah on 20 Dec 2022

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

Patients usually present with slow-growing swelling with or without pain.

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

  • 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 may depict lesions in the soft tissue which can be solitary/multiple unilocular/multilocular/complex cystic lesions and/or atypical solid hypoechoic lesions.

Better delineates expansile unilocular or multilocular lytic lesion and demonstrates any soft tissue extension. Co-existing soft tissue multilocular cysts may be seen.

  • T1: hypointense cyst

    • may show low-intensity rim

  • T1 C+: shows wall enhancement

  • T2: hyperintense cyst (uni/multilocular) with a low-intensity rim

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Cases and figures

  • Case 1: primary hydatid cysts of the soft tissues
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  • Case 2: within vastus lateralis muscle
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  • Case 3: pelvic bones
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  • Case 4: iliacus muscle
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  • Case 5: shoulder
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