Polyosteotic Hydatidosis with Pathological Fracture: A Case Report
Author(s): Rebar M. Noori Fatah
Introduction: A Hydatid disease of the bone is a rare presentation of hydatid disease since it accounts for 4% of the infection rate, which mostly involve the lungs and liver, the human being is infected with contaminated food that contain eggs and it represent the intermediate stage of the disease transmission.
Case presentation: A 55 years old male who was a known case of hydatid disease of the tibia and distal femur presented with gradual onset of right hip pain which made him bed ridden, serological test proved the infection, MRI showed heavy infection of the proximal femur.
Discussion: Bone involvement is very slow process owing to the compact nature, the parasites replaces the hard tissue of the bone and eventually breaches the outer cortex and spread to the soft tissue around the bone, multiple bone involvement is rare, since there are few reports of coincedence existence of pelvis and proximal femur. Skeletal hydatid disease is notorious for its high recurrence rate especially when it involve the coxofemoral and pelvic region, so it is wise to offer radical treatment from the start in a way similar to bone tumors with adjuvant chemotherapy and radiotherapy, however extensive surgeries in this region carries a high risk of complications.
Conclusion: Multiple bony hydatid cyst involvement with pathological fracture is a rare presentation in the lower limb, the importance of early diagnosis is paramount to avoid major complication especially in the coxal region of the femur, skeletal survey is an important step to avoid missing skip lesions.