Musculoskeletal hydatid infection

Last revised by Dr Bahman Rasuli on 09 Mar 2021

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 most common locations are:

  • vertebrae (see spinal hydatid disease) and para-vertebral soft tissue
  • pelvis
  • femur and soft tissue of lower limb
  • 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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