Article Text

THU0367 Joint echinococcosis: A report of three new cases
  1. W. Hamdi1,
  2. M.M. Ghannouchi1,
  3. M. Bouaziz2,
  4. F.M. Ladeb2,
  5. M.M. Kchir1
  1. 1Rheumatology
  2. 2Radiolgy, Kassab Institute, Manouba, Tunisia


Background Joint hydatidosis is defined as the development within the joint of multiple cysts that are the larval form of the tapeworm echinococcus granulosus. Bone and joint cysts account for less than 0.5% of all hydatid cysts in human. We report three cases of joint hydatidosis.

Results Case 1: A 63-year-old woman, who was operated 4 times for lung and liver cyst hydatidosis, was complaining of right inflammatory lumbosciatica S1. Examination revealed pain when pressing the sacral region. X-rays revealed a heterogeneous lesion of the right sacrum. Computed tomography showed an eleven-mm diameter cyst in the right buttock joint with an anterior development into the pelvic cavity. Muscles were not involved. Surgical enucleation of the cysts was performed. Histopathologic examination showed germinative membranes of the hydatid cyst confirming the diagnosis.

Case 2: A 35 year old man with history of right hip pain for the past 5 years and a progressive loss of motion range. Examination found a painful and restricted right hip movement in all directions. X-rays and computed tomography scan showed bone destruction of the hip, multiple cysts and ectopic calcifications around the joint. Serological test for hydatid disease was positive (1/280), confirming the diagnosis of hip hydatidosis.

Case 3: A 39 year old women with history of liver hydatid cyst treated with surgery 14 years ago, was complaining of right shoulder pain for the past year. Examination revealed diffuse swelling of right shoulder with painful and restricted movement in all directions. X-rays showed multiple cysts of the shoulder with pathological fracture of the humerus diaphysis. MRI and hydatid serological test confirmed the diagnosis.

Conclusions Hydatid cysts still occur in Tunisia despite prevention programs. The liver and the lung are the most frequent targets. The joint involvement is uncommon but severe. Joint contamination is usually local from bone lesion and rarely by blood or lymph vessels. Surgical excision of cysts is the main treatment but recurrence is possible particularly at proximal joint that are difficult to access.

Disclosure of Interest None Declared

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