Role of ultrasonography and magnetic resonance imaging in the diagnosis of intramuscular cysticercosis

Abstract

Cysticercosis may manifest as isolated muscular swelling without neurological or ocular involvement. Clinicians should be aware of this clinical condition to avoid misdiagnosis. Ultrasonography and magnetic resonance imaging are good diagnostic aids to establish soft tissue cysticercosis.

Isolated intramuscular cysticercosis: Clinicopathological features, diagnosis and management – A review

“…21 Typically, the cyst is hypointense on T1 weighted images (WI), hyperintense on T2WI, oval or elliptical directed along the course of muscle fibers. 28 There is presence of post-contrast perilesional enhancement. 28 Scolices can range from 1.5 to 2.5 mm in thickness with intermediate to low signal intensity on T2WI and of intermediate signal within the low-signal fluid on T1WI.…”

“…28 There is presence of post-contrast perilesional enhancement. 28 Scolices can range from 1.5 to 2.5 mm in thickness with intermediate to low signal intensity on T2WI and of intermediate signal within the low-signal fluid on T1WI. 21 Edema of varying degrees can be seen in all the cases.…”

“…There may be raised ESR and eosinophil counts that may indicate a helminthic infection. 28 Eosinophilia is transient and is seen in the early course of the disease associated with migration of the larvae through blood or tissue. 22 …”

“…28 Radiological evaluation is often needed to clinch the diagnosis early. The diagnosis of intramuscular cysticercosis can be difficult clinically with several clinical differentials such as lipomas, epidermoid cysts, neuroma, neurofibromas, pseudoganglia, sarcoma, myxoma, pyomyositis, cold abscess or tuberculous lymphadenitis.…”

“…40,41 However modern imaging techniques have obviated the need for a formal histologic confirmation. 28,42 Fine needle aspiration cytology (FNAC) is rapid, safe, cheap, and reliable diagnostic tool for such lesions and it may obviate the need for future biopsy. 43,44 On cytology there are eosinophils, neutrophils, palisading histocytes and epithelioid cell granulomas with giant cells.…”