title: Skeletal manifestations of hydatid disease in Serbia: demographic distribution, site involvement, radiological findings, and complications.
abstract: Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9±18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.
authors.affiliation: Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade 11000, Serbia. ; Department of Radiology, School of Dental Medicine, University of Belgrade, Belgrade 11000, Serbia.
authors.forename: Djurdja
authors.initials: D
authors.lastname: Bracanovic
authors.forename: Marija
authors.initials: M
authors.lastname: Djuric
authors.forename: Jelena
authors.initials: J
authors.lastname: Sopta
authors.forename: Danijela
authors.initials: D
authors.lastname: Djonic
authors.forename: Nenad
authors.initials: N
authors.lastname: Lujic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001847:Bone Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000469:parasitology*; D002648:Child; D002675:Child, Preschool; D004443:Echinococcosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000469:parasitology*; D048209:Echinococcus granulosus / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D055815:Young Adult
keywords: Echinococcus granulosus; Serbia; bone; echinococcosis; pain; pathological fracture
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