Presentation Patterns, Diagnostic Modalities, Management Strategies, and Clinical Outcomes in Patients with Hydatid Disease of the Pelvic Bone: A Comparative Review of 31 Cases

Inayat, Faisal; Shoaib, Azam; Baig, Areeba S; Nawaz, Gul; Ullah, Waqas

doi:10.7759/cureus.4178

Cited by 9 publications

(15 citation statements)

References 33 publications

(27 reference statements)

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“…Heat generated inside the cemented filling raises the local temperature, causing necrosis of the daughter cysts. It has been demonstrated that the recurrence considerably decreased in patients who had been treated with bone cement technique, denoting an excellent long-term prognosis [17].…”

Section: Discussionmentioning

confidence: 99%

“…Complete excision and large bone grafting, total hip replacement, femoropubic arthrodesis, megaprosthetic replacement, osteosynthesis, and hemipelvectomy are included among other surgical modalities for the treatment of hydatid disease of the pelvic bone [17]. Pelvic hydatidosis is relatively difficult to diagnose at early stages because of its surreptitious progression.…”

Section: Discussionmentioning

confidence: 99%

“…Early and aggressive treatment using complete surgical excision coupled with appropriate adjuvant and/or neoadjuvant chemotherapy is the key to improve the prognosis and decrease the recurrence risk. Radiotherapy is also an effective adjunct to the surgery, especially in patients with contraindication to medical therapy [17].…”

Section: Discussionmentioning

confidence: 99%

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Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Inayat

Rana

Shoaib

et al. 2019

Cureus

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Hydatid disease is one of the most complicated and devastating conditions caused by Echinococcus granulosus . This globally distributed disease continues to be an important public health concern in many low- and middle-income countries. The liver and the lungs are the most frequently involved sites, but virtually any organ system can be affected. Osseous hydatidosis is relatively less common, but it is extremely debilitating and difficult to manage due to frequent recurrences. Patients often demonstrate a delayed clinical presentation as bone involvement is predominantly a silent and slowly progressive disease with a long latent period. Radiological investigations play an important role in the diagnosis. Although standard therapeutic guidelines are not available, the treatment of choice is a combination of chemotherapy and surgery. Clinicians should perform a lifelong follow-up for early detection of potential recurrence and sequels. This paper aims to highlight hydatid disease of the pelvic bone as an important differential diagnosis of tubercular hip arthritis, especially in areas with high echinococcosis prevalence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Inayat

Rana

Shoaib

et al. 2019

Cureus

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“…Therefore, this disease warrants awareness and updated knowledge on part of clinicians, especially in endemic areas when patients present with generalized musculoskeletal complaints. Early radiologic investigations, laboratory evaluation, such as serological detection, and histopathologic analysis of the biopsy specimen are of paramount importance [ 3 ]. Serological tests are important in differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the recurrence rate of pelvic cystic echinococcosis is high, and the repeated course of disease can easily lead to secondary infection, or the interruption of treatment can lead to long-term wound healing, resulting in subcutaneous abscess or fistula [ 3 ], which requires long-term catheter drainage. Chronic osteomyelitis of the pelvis is rare, characterized by pathological changes such as dead bone, sinus, dead cavity, and cladding.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of imaging features of pelvic echinococcosis based on multimodal images

Chen¹,

Aikebaier²,

Zhao³

2020

J Orthop Surg Res

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Background Hydatid disease (HD) is a zoonotic parasitic disease caused by the larvae of Echinococcus, It is mainly prevalent in pastoral areas. Bone echinococcosis is rare, accounting for 0.5 to 4.0% of all echinococcosis. It is likely to miss the diagnosis and misdiagnose due to non-specific early symptoms and the clinical manifestations and imaging features. The clinical data of 15 patients with pelvic cystic echinococcosis were analyzed retrospectively, and the X-ray, CT, and MRI imaging features of the disease were discussed, which are reported below. Methods All 15 patients underwent CT scan evaluation. A total of 8 patients underwent coronal, sagittal, and three-dimensional reconstruction with 3-mm-slice thickness, and 4 patients underwent X-ray plain film examination. Five cases underwent MRI scan. Eight cases underwent MRI or CT enhanced scan. Results X-ray plain film is characterized by continuous cystic bone destruction, irregular low-density shadow when invading soft tissue, and sometimes calcification which can be seen on the wall or inside the cyst. The involved sacroiliac joint or hip joint may narrow or disappear. The involvement of pelvic cystic echinococcosis is relatively wide, and 80% of patients with pelvic cysts in this group had multiple lesions in the same period. Cystic expansive bone destruction was the most common. Pelvic CT revealed a lobulated hypodense lesion of varying size with internal septae, causing cortical thinning and destruction. Most of them had no periosteal reaction. The iliopsoas muscle is most easily invaded. Single cystic echinococcosis of pelvis showed intermediate or low signal intensity on T1-weighted images and hyperintensity on T2-weighted images in the involved bone and surrounding soft tissue on MRI, and the cyst wall showed linear low signal in T1WI, T2WI, and STIR sequences. The polycystic type is characterized by multiple cysts of varying signal intensity (daughter cysts) within a larger cyst is the typical MRI finding, forming “small vesicles” high signal daughter cysts. Osteosclerosis or calcification showed low signal in T1WI and T2WI. Conclusions The results of this study suggest that the lesions of pelvic cystic echinococcosis are mostly cystic expansive and osteolytic bone destruction, which is easy to invade the surrounding soft tissue, often accompanied with calcification; among them, multiple cystic lesions are characteristic.

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Vertebral and pelvic echinococcosis in northwestern China

Yang

Tuxunjiang

Liu

et al. 2023

International Orthopaedics (SICOT)

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Purpose Echinococcosis remains a major economic and severe public health problem in endemic areas. Bone echinococcosis is rare, and the vertebra and pelvis are the most common sites of echinococcosis involving the skeletal. Because of the clinical severe symptoms and high recurrence rate, it brings excellent trouble to patients. Methods This study retrospectively analyzed the clinical manifestations, laboratory tests, radiological findings, and treatment of 44 patients with vertebral and pelvic echinococcosis during a period of 16 years (2005–2020). Results The mean age was 43 years (25 males, 19 females; 19–68 years). The most common symptom was pain, followed by numbness, weakness, activity limitation, and progressive paraparesis. Enzyme-linked immunosorbent assay test (ELISA) results were positive in 18 cases (75%). There are 24 cases of hydatid infection of the spine, 14 hydatid infection of the pelvis, and six hydatid infection of both vertebra and pelvis. The site of infection was 13 (29.5%) thoracic, five (11.4%) lumbar, four (9.1%) lumbosacral, seven (15.9%) sacral, 19 (43.2%) ilium, seven (15.9%) hip, six (13.6%) ischium, five (11.4%) pubis, and two (4.5%) femur, respectively. The imaging findings were cystic dilatancy, septal, and irregular bone destruction. MRI has a special value in showing the relationship between the surrounding tissues and organs of cystic bone echinococcosis. All patients were followed up for at least one year. The mean follow-up time was 3.6 years. Conclusions Even in epidemic areas, the incidence of bone echinococcosis is relatively rare. However, when encountering the vertebral and pelvic destruction, consider bone echinococcosis’s possibility, especially for the herdsmen in endemic regions.

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Presentation Patterns, Diagnostic Modalities, Management Strategies, and Clinical Outcomes in Patients with Hydatid Disease of the Pelvic Bone: A Comparative Review of 31 Cases

Cited by 9 publications

References 33 publications

Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Evaluation of imaging features of pelvic echinococcosis based on multimodal images

Vertebral and pelvic echinococcosis in northwestern China

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