Osteometric Study Of Proximal Femur

Background: The constitutional built and physique of Indians is entirely different from the western populationdue to the variation in the genetic makeup and lifestyle. But the prosthesis for proximal femur used in India ismanufactured by the western countries whose morphometry does not fit our people leading to complications.Hence, this study is to provide the morphometric data of proximal femur for Indian population and to clear thedrawbacks in the information about proximal femur in our people and customize the implant design to suit theIndian people and thereby reduce the complications.Materials and Methods: The study material consisted of 60 dry femora obtained from the Institute of Anatomyand the parameters studied according to standard anthropometrical methods with appropriate instruments.Results: In the present study, the average length of the femur was 41.4cm, diameter of head was 4.17cm, anteriorneck length being 3.42cm, Neck- shaft angle was 129.90and the inter-trochanteric distance 6.13cm.Conclusion: This study showed that our values were comparatively smaller than the western people and variedwith regional ethnicity. This study will encourage our biomechanical engineers to bring in a revolution in thedesigning and manufacturing of implants with correct morphometric data to befit our Indian population andlead to improved surgical outcome with minimal surgical complications.

Primary thyroid tuberculosis: a rare etiology of hypothyroidism and anterior cervical mass mimicking carcinoma / Tuberculose tireoidiana primária: rara etiologia de hipotireoidismo e massa cervical anterior mimetizando carcinoma

OBJECTIVE: The involvement of the thyroid by tuberculosis (TB) is rare. Hypothyroidism caused by tissue destruction is an extremely rare report. Our aim was to report a patient with primary thyroid TB emphasizing the importance of diagnosis, despite the rarity of the occurrence. CASE REPORT: Women, 62 years old, showing extensive cervical mass since four months, referring lack of appetite, weight loss, dysphagia and dysphonia. Laboratorial investigation revealed primary hypothyroidism. Cervical ultrasound: expansive lesion in left thyroid lobe, involving adjacent muscle. Computed tomography scan: 13 cm diameter cervical mass with central necrosis. Fine needle biopsy: hemorrhagic material. Surgery: total thyroidectomy, left radical neck dissection and protective tracheotomy. The pathological examination showed chronic granulomatous inflammatory process with areas of caseous necrosis and lymph node involvement. The thyroid baciloscopy was positive. Pulmonary disease was absent. The patient was treated with antituberculosis drugs. CONCLUSIONS: Thyroid TB is not frequent, and should be considered as differential diagnosis of hypothyroidism and anterior cervical mass.

OBJETIVO: A tuberculose tiroidiana ocorre raramente. O hipotireoidismo decorrente da destruição tiroidiana é um relato raríssimo. Nosso objetivo foi descrever o caso de paciente com tuberculose tiroidiana primária e ressaltar a raridade e a importância da doença. RELATO DO CASO: Mulher, 62 anos, apresentando massa cervical extensa há quatro meses, associada à inapetência, à perda de peso, à disfonia e à disfagia. A investigação laboratorial mostrou hipotireoidismo primário. Ultrassonografia: lesão expansiva em lobo esquerdo, envolvendo musculatura subjacente. Tomografia computadorizada: massa heterogênea com centro necrótico, 13 cm de diâmetro. Biópsia por agulha fina: material serossanguinolento. Cirurgia: tireoidectomia, dissecção radical à esquerda e traqueostomia protetora. Exame anatomopatológico: processo inflamatório crônico granulomatoso com áreas de necrose caseosa e comprometimento linfonodal. Baciloscopia tiroidiana positiva. Ausência de comprometimento pulmonar. A paciente foi tratada com drogas antituberculosas. CONCLUSÕES: Tuberculose tireoidiana não é frequente, mas deve ser considerada como diagnóstico diferencial de hipotireoidismo e massa cervical anterior.

2 Cases of Peripheral Nerve Tumors of Anterior Neck Simulating Thyroid Nodule / 대한내분비학회지

Peripheral nerve tumors are mostly benign and can arise on any nerve trunk or twig. Although peripheral nerve tumors can occur anywhere in the body, including the spinal roots and cauda equina, many cases are subcutaneous in location and present as a soft swelling, sometimes with a purplish discoloration of skin. There are two major catagories, schwannoma(neurilemmoma), and neurofibroma. Schwannomas are usually solitary and grow in the nerve sheath, rendering them relatively easy to dissect free. In contrast, neurofibromas tend to be multiple, grow in the endoneural substance, which renders them difficult to dissect, may undergo malignant changes, and are the hallmark of von Recklinghausens neurofibromatosis. Masses in the anterior part of neck may be initially thought to be thyroid nodule and then other cervical masses should be considered. The diagnosis rests on clinical suspicion and diagnostic support may be obtained by CT scan, magnetic resonance imaging(MRI) and substraction angiography in the literature. After imaging, fine needle aspiration for cytology may be helpful. If they are resected unrecognized and/or without regard to their nerve origin, major and permanent nerve defects can unnecessarily occur. We experienced 2 cases of peripheral nerve tumors of anterior neck simulating a thyroid nodule.