Joshi Nayana, Hernandez-Martinez Alejandro, Seijas-Vazquez Roberto
Hospital Universitari Vall d'Hebron, Departament de Cirurgia Ortopèdica y Traumatologia, Barcelona, Spain.
Acta Orthop Belg. 2007 Oct;73(5):674-7.
This case report highlights an unusual osseous spinal presentation of a well described disease, hydatidosis. A 59-year-old woman presented with increasing back pain and bilateral radiculopathy. Examination disclosed symptoms of spinal stenosis and urinary incontinence. Radiographs showed an expansive lytic lesion affecting the pelvic bones with destruction of the bone cortex. Laboratory analyses were performed and the patient underwent CT and MRI studies. Serology for Echinococcus was positive. When assessing sciatica, low back pain or lower limb weakness the pelvic cavity should be examined for hidden disease that might explain the neurological symptoms. Hydatid disease of bone should be considered in the differential diagnosis of any bone mass discovered in the human body. Diagnosis was delayed in this case because the pelvic cavity was not studied when radiculopathy symptoms started and there was no coexisting visceral involvement.
本病例报告突出了一种已被充分描述的疾病——包虫病不寻常的脊柱骨表现。一名59岁女性因背痛加重和双侧神经根病就诊。检查发现有椎管狭窄和尿失禁症状。X线片显示一个累及骨盆骨的膨胀性溶骨性病变,伴有骨皮质破坏。进行了实验室分析,患者接受了CT和MRI检查。棘球绦虫血清学检查呈阳性。在评估坐骨神经痛、腰痛或下肢无力时,应检查盆腔是否存在可能解释神经症状的隐匿性疾病。在人体发现的任何骨肿物的鉴别诊断中都应考虑骨包虫病。该病例诊断延迟是因为神经根病症状出现时未对盆腔进行检查,且不存在并存的内脏受累情况。