Hydatid disease is the most common human disease caused by helminths,
but primary skeletal involvement is uncommon. Diagnosis is usually obt
ained late after considerable extension, half of which concerns the sp
ine. The dissemination mode leads to local malignancy with severe prog
nosis. Medical imaging is essential. Plain x-ray findings are polymorp
hous and nonspecific, but computed tomography and magnetic resonance i
maging are particularly useful for exhaustive pretherapeutic assessmen
t of extension and for patient follow-up.