Department of Orthopaedics, University of the Witwatersrand, 7 York Road Park-Town, Johannesburg, South Africa.
Orthopaedic Oncology and Infections Unit, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, 7 York Road, Park-Town, Johannesburg, 2193, South Africa.
J Med Case Rep. 2023 Dec 27;17(1):531. doi: 10.1186/s13256-023-04275-4.
Hydatidosis is a parasitic infection caused by Echinococcus granulosus and humans are usually an accidental intermediate host. Involvement of the musculoskeletal system is reported to occur in 0.5% to 4% of the cases.
We present our experience with two cases of musculoskeletal hydatidosis in black African patients that required orthopaedic surgical intervention. A 51-year-old black African female presented with right hip hydatid disease and a 37-year-old black African female presented with the disease affecting the left shoulder. Both patients presented with joint pain and reduced range of motion. The patient with involvement of the shoulder had a background history of human immunodeficiency virus, this was not present with the other patient. Diagnostic work-up confirmed peri-articular hydatid disease and both patients were surgically managed with arthroplasty. Post-operative complications encountered include hardware loosening from bone lysis and hardware failure.
The medical literature describes a limited number of cases of peri-articular musculoskeletal hydatid disease. Patients are often subjected to many investigations, prolonged treatment periods and multiple surgeries. Concurrent use of medical and surgical treatment is advocated however, the choice of surgery is individualised.
Hydatid disease must always feature in the differential diagnosis of multiple lytic bone lesions and radical surgical intervention may be required from the outset.
包虫病是一种由细粒棘球绦虫引起的寄生虫感染，人类通常是偶然的中间宿主。据报道，骨骼肌肉系统受累发生率在 0.5%至 4%之间。
我们报告了两例在非洲黑人患者中发生的骨骼肌肉包虫病病例，这些病例需要进行骨科手术干预。一名 51 岁的非洲黑人女性因右侧髋关节包虫病就诊，另一名 37 岁的非洲黑人女性因左侧肩部包虫病就诊。两名患者均出现关节疼痛和活动范围受限。肩部受累的患者有人类免疫缺陷病毒病史，而另一名患者则没有。诊断性检查证实为关节周围包虫病，两名患者均接受了关节置换术治疗。术后并发症包括骨溶解导致的硬件松动和硬件失败。
医学文献描述了少数关节周围骨骼肌肉包虫病病例。患者通常需要接受多项检查、延长治疗时间和多次手术。提倡同时使用内科和外科治疗，但手术选择是个体化的。
包虫病必须始终作为多发溶骨性骨病变的鉴别诊断之一，可能需要从一开始就进行根治性手术干预。
