Recurrent costovertebral hydatidosis with epidural extension

Osseous echinococcosis is a relatively rare entity and that of the rib is even rare. Few cases of costal echinococcosis have been reported in the literature so far. We report a case of a recurrent costovertebral hydatidosis with epidural extension in a 49-year-old man who presented with paraparesis and back pain. MRI of the dorsal spine was performed. The imaging features were suggestive of echinococcosis involving the rib and vertebrae with epidural extension. This diagnosis was confirmed histopathologically after surgical treatment. The evolution was marked by the reappearance of the same symptoms due to recurrence. The prognosis of costovertebral hydatidosis is gloomy despite radical surgical treatment due to the frequency of recurrences. This case highlights the role of MRI for the diagnosis and follow-up of patients after treatment.