E3409. Imaging of Musculoskeletal and Soft Tissue Manifestations of Parasitic and Vector-Born Infections
  1. Nadia Solomon; Yale School of Medicine
  2. Francisco Calle; Hospital Militar Central
  3. Pedro Lino; Instituto de Radiologia do Hospital das Clínicas FMUSP
  4. Yashant Aswani; University of Iowa Carver College of Medicine
  5. Angel Donato; Hospital Militar Central
  6. Vikram Dogra; University of Rochester Medical Center School of Medicine and Dentistry
  7. Margarita Revzin; Yale School of Medicine
As the frequency and ease of emigration and international tourism have increased, many parasitic infections which were previously considered as local or regional problems are now being observed all over the world. There has been a similar effect on various vector-borne infections (both parasitic and nonparasitic) which have been additionally impacted by climate changes, allowing for expansion of the geographic distribution of numerous arthropod vectors and, subsequently, the diseases they carry. As more of these infections crop up in unexpected locations, and especially if a connection is not made with either a history of travel or a relevant arthropod vector, diagnosis and treatment can be significantly delayed. Knowledge of these infectious agents and their manifestations can allow the radiologist to recognize the relevant imaging findings and potentially be the first to suggest the diagnosis.

Educational Goals / Teaching Points
This exhibit aims to familiarize the radiologist with the variety of parasitic and vector-borne diseases which infect humans, focusing on musculoskeletal manifestations. This will include a brief introduction to the epidemiology of these conditions, and a broader look at the clinical presentations and medical complications/sequelae of these infections as they pertain to musculoskeletal imaging. The exhibit will provide an array of case examples which demonstrate the imaging features associated with both acute and chronic, and common and uncommon sequelae of vector-borne and parasitic infections across multiple imaging modalities. It will also provide a brief overview of management and treatment of these infections.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review parasitic and vector-borne infections resulting in musculoskeletal disease manifestations, including protozoan parasites (e.g., cutaneous leishmaniasis, giardiasis), helminths (e.g., cystic echinococcosis, filariasis), vector-transmitted bacteria (e.g., anaplasmosis, Lyme disease), and other conditions (e.g., myiasis). It will provide a multimodality review of imaging findings, including radiography (e.g., calcified guinea worm), sonography (e.g., filarial dance sign, onchocercomata, myiasis), CT (e.g., cysticercosis, Lyme-associated myositis), and MRI (e.g., cysticercosis, Lyme-associated arthritis). It will review specific (e.g., disseminated cysticercosis, cystic echinococcosis) and nonspecific (e.g., Giardia synovitis) findings, as well as common (e.g., mucocutaneous leishmaniasis, intramuscular cysticercosis) and uncommon musculoskeletal manifestations (e.g., bullous rash secondary to anaplasmosis) of these diseases.

With increasing world travel and climate changes, vector-borne and parasitic infections are being seen more frequently on an international basis. A radiologist armed with knowledge of these infectious agents and their sequelae can make major contributions to timely patient care by recognizing the salient imaging findings and suggesting the diagnosis.