Purpose: Reports remain sparse on the outcomes of quadratus femoris muscle pedicle bone grafting (QF-MPBG) for osteonecrosis of the femoral head (ONFH) in the existing literature. This study reports on the clinico-radiological outcomes of this procedure in early-stage non-traumatic ONFH using a quadriceps-coxae sparing (QCS) modified posterior approach. Materials and Methods: This prospective study included 22 symptomatic patients suffering from early-stage, non-traumatic ONFH. These patients underwent QF-MPBG surgery using a QCS modified posterior approach and were followed up for a minimum duration of 24 months. Results: The mean age of patients was 29 years (range, 20-47 years). As per the modified Kerboul’s combined necrotic angle, the distribution of patients was as follows: grade 1 (n=5); grade 2 (n=9); grade 3 (n=4); and grade 4 (n=4). All four patients belonging to grade 4 and two belonging to grade 3 required total hip arthroplasty (THA) within 24 months. As per the modified Ficat’s classification, 18 cases were in stage II and four in stage I. Six cases (out of the preoperative 18 cases classified as stage II) deteriorated to stage IV, and two deteriorated to stage III. The mean Harris hip score improved from 63 (range, 57-67) to 75 (range, 50-93) after surgery (P<0.05). Four out of six patients necessitating THA had steroid-induced ONFH. Conclusion The QCS modified posterior approach provides sufficient exposure required for QF-MPBG. Steroid-induced ONFH and a modified Kerboul’s combined necrotic angle of >250° may be considered as potential risk factors for progression of this disease.

Nonalcoholic fatty liver disease (NAFLD) has been shown to be linked to inflammatory bowel disease (IBD) due to established risk factors such as obesity, age, and type 2 diabetes in numerous studies. However, alternative research suggests that factors related to IBD, such as disease activity, duration, and drug-induced toxicity, can contribute to NAFLD. Recent research findings suggest IBD relapses are correlated with dysbiosis, mucosal damage, and an increase in cytokines. In contrast, remission periods are characterized by reduced metabolic risk factors. There is a dichotomy evident in the associations between NAFLD and IBD during relapses and remissions. This warrants a nuanced understanding of the diverse influences on disease manifestation and progression. It is possible to provide a holistic approach to care for patients with IBD by emphasizing the interdependence between metabolic and inflammatory disorders.

We report the case of a 20-year-old man with a constellation of anomalies - a functional thyroglossal cyst and concurrent ectopic thyroid in the floor of the mouth, without an orthotopic thyroid gland. To our knowledge, this is the third such report in the otolaryngology literature. It is important to be aware of the possibility of concurrent ectopic thyroid and thyroglossal cyst in the absence of an orthotopic thyroid gland. The majority of reported cases of thyroid ectopy occur at the base of the tongue. The occurrence of an ectopic thyroid in the floor of the mouth is both unusual and not amenable to clinical examination. Even if there is good uptake on nuclear imaging, the ectopic thyroid may be hypofunctioning. We discuss the importance of thyroid imaging, as well as the need for preoperative imaging and an appropriate management strategy in the treatment of patients with this triad of anomalies.
Contrast Media ; Humans ; Male ; Mouth Floor ; diagnostic imaging ; pathology ; surgery ; Thyroglossal Cyst ; complications ; diagnostic imaging ; surgery ; Thyroid Dysgenesis ; complications ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Young Adult