Hydatid disease: A rare cause of fracture nonunion

Complete excision of giant clavicular hydatid cyst: a case report

BACKGROUND

Echinococcosis, also known as hydatid disease, is a zoonotic parasitic disease prevalent in pastoral areas, mainly involving the liver and lungs, and less frequently the bones and surrounding soft tissues. Diagnosis and treatment of bone hydatid disease is a challenge, and because of the insidious course of the disease, the lesions are often widely disseminated by the time patients seek medical attention.

CASE PRESENTATION

A 29-year-old woman presented with a painless mass that was gradually increasing in size in the cervical thorax. Imaging revealed an enlarged clavicle with multiple bone cortical defects and the existence of cysts in the soft tissues surrounding the clavicle, for which complete excision of the clavicle and the attached cysts was performed. There was no recurrence of the cyst within one year after the operation, and the patient felt well and had normal shoulder joint movement.

CONCLUSIONS

Bone hydatid may appear in bones throughout the body, and cysts that leak from the bone into the surrounding soft tissues may spread at a relatively rapid rate. Prompt surgical removal of the affected bone and surrounding cysts is necessary for treatment.

An Unusual Cause of Knee Mass: Osseous Hydatidosis

Hydatid disease (hydatidosis) is a zoonotic infection caused by the larval stage of the parasitic tapeworm Echinococcus granulosus endemic in some sheep-raising areas. The liver and lungs are most commonly affected. Bone involvement (osseous hydatidosis) is distinctly uncommon, and its diagnosis and treatment can be challenging. We report a case of a 54-year-old male with right knee pain and edema and an extensive lesion on the femur; he was diagnosed with knee hydatidosis and was successfully treated with surgery and albendazole. This case reinforces the importance of the rare osseous hydatidosis as part of the differential diagnosis of bone lesions.

Segmental Defect-Bridging Intramedullary Knee Arthrodesis for Osseous Hydatidosis of the Distal Femur: A Case Report

Hydatid cyst is a condition endemic to many parts of the world and is mainly caused by Echinococcus granulosus (E. granulosus). It rarely affects the bone tissue, with the most commonly impacted sites being the vertebrae and the pelvis. Preoperative diagnosis is challenging and very rarely possible because of its similarities with other pathologies. In this report, we present the case of a 64-year-old patient with osseous hydatidosis of a pathological distal femur fracture. The fracture pattern was not recognized on the initial operation and multiple serial debridements were required to control the disease, leading to a large bone defect and a weakened extensor mechanism. A knee arthrodesis with a segmental defect-bridging intramedullary system was eventually performed, which led to satisfying outcomes.

Osseous hydatidosis very often presents itself as a pathological fracture and is difficult to diagnose preoperatively with plain radiographs. Orthopedic surgeons are advised to maintain a high index of suspicion and to test for this disease when cystic bone lesions are detected at fracture sites, especially in patients from endemic regions.