Spinal hydatid disease
Chronic back pain. No past history of surgery.
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Collapsed L3, L4, and L5 vertebral bodies (mainly of L4) of multivesicular appearance of low signal intensity on T1WI, and high signal intensity on T2WI, with involvement of the posterior vertebral elements as well as the posterior portion of L4-L5 disc space with intraspinal extension (extra-dural) well-visualized on axial T2 sequence.
Multiple intramuscular multivesicular cysts of the psoas muscles (mainly on the left) and right multifidus muscle, seen as multiple daughter cysts of various size within the mother cysts with thin peripheral rim enhancement. Note atrophied right paraspinal muscles with fatty degeneration.
MRI features characteristic of spinal hydatid disease types 3, 4, and 5 according to the Dew/Braithwaite & Lees classification with additional hydatid cyst of the lung (right upper lobe).
Spinal hydatid disease is uncommon; the thoracic spine is the most commonly affected region.
Additional contributor: C. Boukaaba, MD.