UNASSIGNED: Osteonecrosis is a common complication, particularly in HIV-infected patients undergoing long-term glucocorticoid therapy. This case report aims to highlight the unique \"map-like\" magnetic resonance imaging (MRI) changes observed in an HIV-positive patient with multiple osteonecrosis due to glucocorticoid overdose, emphasizing the importance of recognizing and managing this complication in this high-risk population.
UNASSIGNED: A 29-year-old HIV-positive male patient developed extensive multi-joint osteonecrosis involving 7 joint sites (right shoulder, bilateral hips, bilateral knees, and bilateral ankles) after 6 months of high-dose glucocorticoid treatment for an opportunistic pneumonia associated with his HIV status. The patient required prolonged glucocorticoid therapy to manage the severe lung infection. MRI revealed characteristic \"map-like\" changes, with the osteonecrotic areas distributed in a linear, clustered, or map-like pattern. To alleviate his condition and improve joint function, the patient underwent a customized treatment plan, including total hip replacement for the left hip, core decompression surgery for the right hip. Following surgical intervention, the patient experienced reduced joint pain and improved joint mobility.
UNASSIGNED: This case underscores the potential risk of extensive multi-joint osteonecrosis in HIV-positive patients receiving long-term high-dose glucocorticoids, with the \"map-like\" MRI changes being a distinctive imaging feature. It emphasizes the importance of close monitoring and timely implementation of effective interventions in this high-risk population. Notably, core decompression surgery can improve local blood circulation, slow disease progression, and serve as an effective minimally invasive treatment option for early-stage osteonecrotic lesions.

UNASSIGNED: Avascular necrosis of the lunate bone has been extensively researched, although the etiology of the condition remains controversial. Even though many treatments for the disease exist, a better understanding of the pathophysiology can improve our decision-making between preventive and therapeutic measures. Various hematological disorders have been found to predispose for Kienböck\'s disease. On the other hand, there has not yet been any reference in literature to a relationship between this condition and hereditary hemochromatosis (HH).
UNASSIGNED: We present two cases of Kienböck\'s disease in two patients who are third-degree relatives and diagnosed with HH. A 61-year-old Caucasian female patient with type 1 HH presented with symptomatic Kienböck\'s disease on the left side. The patient is a third-degree relative of a 51-year-old male Caucasian patient with Kienbock\'s disease on the right side, known as having the same hereditary hematological condition.
UNASSIGNED: Our findings suggest a potential correlation between the aforementioned conditions. The prevalence of these coexisting pathologies should be studied further.

UNASSIGNED: Immune checkpoint inhibitors (ICIs) are increasingly being used in the treatment of advanced metastatic and immunogenic cancers. However, these therapies could cause immune-related adverse events (irAEs), which require high-dose glucocorticoid administration.
UNASSIGNED: A 52-year-old man with metastatic renal cell carcinoma received ICI therapy. Two weeks later, he suffered from severe irAEs and received glucocorticoid therapy for 13 months. Twenty-one months after the initiation of glucocorticoid administration, he presented to us with bilateral hip pain and was diagnosed with bilateral osteonecrosis of the femoral head (ONFH).
UNASSIGNED: IrAEs associated with ICI therapy might be an emerging underlying disease of ONFH.

Candida osteomyelitis, in general, is a relatively rare manifestation compared to its bacterial counterparts. The mandible\'s involvement is rarer, lacking established management and fewer guidelines. Herein, we aim to illustrate the significant challenge in treatment, namely due to the persistent and resistant nature of Candida albicans-associated biofilm. A multidisciplinary approach involving adjunctive use of antifungals with surgical interventions is typically necessary and feasible in this case. However, surgical interventions may not always be possible in challenging instances in which the patient may be structurally (including osteoradionecrosis) and vascularly compromised, raising questions about the feasibility of standard-of-care as well as the success of alternative therapies aimed at disrupting biofilm formation. Clinicians should maintain a high index of suspicion for complicating, deep-seated Candidiasis in at-risk populations and endeavor to treat as aggressively as possible to limit recurrent disease owing to persistence.

BACKGROUND: There are several surgical options for osteonecrosis of the lunate, and confirming the effectiveness of various surgical methods remains challenging. Here, we present a case of stage IIIB osteonecrosis of the lunate repaired with a free medial femoral condyle osteocutaneous flap.
METHODS: A 43-year-old male construction worker was admitted to our hospital due to right wrist pain, impaired mobility, and pain aggravated by activity for 10 months. The patient was diagnosed with stage IIIB osteonecrosis of the lunate based on the orthopantomogram and magnetic resonance imaging of the right wrist. Considering the patient\'s medical history, physical examination, auxiliary examination, and wishes, reconstruction was performed using a free medial femoral condyle osteocutaneous flap. After the flap survived completely, the K-wires were removed one month after the operation, the external brace was removed two months after the operation, and functional wrist rehabilitation was initiated. After six months of follow-up, the wrist swelling and pain resolved, and the reconstructed lunate bone was viable. Additionally, the last follow-up was conducted in the sixth month after surgery; the affected hand grip strength improved from about 70% (28 kg) to 80% (32 kg) compared with the healthy side (40 kg); the visual analog scale score decreased from 6.5 points before the operation to 1 point; and the MAYO score increased from 60 points before the operation to 85 points.
CONCLUSIONS: The success of this case reinforces the potential of the free medial femoral condyle osteocutaneous flap as a new treatment option for stage IIIB osteonecrosis of the lunate and further expands the existing treatment options. Using a free medial femoral condyle osteocutaneous flap to reconstruct the lunate and restore the carpal anatomy may.

BACKGROUND: We present a case of a 29-year-old male patient without immunodeficiency who suffered from rapid osteonecrosis and tooth exfoliation resulting from herpes zoster (HZ) infection in the left maxillary branch of the trigeminal nerve. Various complications associated with shingles infections have been reported, cases of osteonecrosis and tooth exfoliation due to HZ infection among young people without immunodeficiency are rare. In this case, we focus on the particular manifestation of HZ infection.
METHODS: The patient presented with clusters of erythema and papules, along with non-hemorrhagic blisters on the left face and the loss of the left upper incisor. All lesions were localized to the left side of the face without exceeding the midline. After receiving antibacterial and antiviral treatment, successful control over the infection was achieved; however, he experienced the loss of all upper teeth on the left side except for the first and second upper left molars.
CONCLUSIONS: This case highlights that rapid osteonecrosis and tooth exfoliation may occur among young individuals without immunodeficiency after HZ infection. HZ infection of the face should be taken very seriously to obtain prompt treatment to prevent the rare complications of bone necrosis and tooth loss as much as possible.

Medication Related Osteonecrosis of the Jaw (MRONJ) has traditionally been mostly attributed to the exposure to antiresorptive agents such as bisphosphonates and denosumab. Nevertheless, following the development of new medications in oncology, the spectrum of drugs associated with MRONJ widened, with, for example, tyrosine kinase inhibitors, mTOR inhibitor, or monoclonal antibodies against VEGF. To date, MRONJ has not been assessed or reported in patients treated with guselkumab so far. Guselkumab is a fully human IgG1λ monoclonal antibody that selectively targets the p19 protein subunit of extracellular human IL-23 and inhibits its intracellular and downstream signalling. It consists of two identical light chains and two identical heavy chains. The four chains are linked together by covalent disulfide bonds and noncovalent protein-protein interactions. The aim of this article is to report a case of a patient with severe psoriasic arhtritis and plaque psoriasis who presented with a clinical condition that could resemble a MRONJ following guselkumab therapy and a dental root extraction.

We report two rare cases of femoral neck fracture resulting from osteonecrosis of the femoral head (ONFH) that was undiagnosed at the patients\' initial visits. The patient in the first case had sequential bilateral displaced femoral neck fractures. Because no osteonecrosis of the femoral head was visible on X-ray film and the data of liver function tests were normal, ONFH was not diagnosed. In addition, because the patient was a 55-year-old man with normal everyday functioning, closed reduction with cannulated screws was performed at both visits. Nine months later, he came to our outpatient department with bilateral hip pain; X-rays revealed nonunion and implant failure at both hips. The patient subsequently underwent bilateral total hip arthroplasty (THA) and had a satisfactory outcome at his 4-year follow-up. The patient in the second case had a left displaced femoral neck fracture after trivial trauma two months prior. ONFH was not diagnosed upon examination of X-ray findings. The patient was 52 years old with liver cirrhosis and had bipolar hemiarthroplasty performed because of a chronic displaced fracture and poor general condition. After 2 years, she began to have right hip pain. X-rays revealed massive necrosis and sclerosis of the femoral head. Computed tomography scans for ONFH staging revealed impending fracture lines at the subcapital site of the patient\'s previous left femoral neck fracture. Right THA was then performed, and the outcome was satisfactory.

UNASSIGNED: Despite being rare, we have presented a case of osteonecrosis of acetabulum that followed total hip arthroplasty. It\'s crucial to act appropriately, as it emulates periprosthetic joint infection. The key point is that the osteonecrosis of acetabulum may necessitate revision and can be classified as aseptic loosening.
UNASSIGNED: Osteonecrosis of the femoral head is well known and managed with total hip arthroplasty (THA). Acetabulum osteonecrosis can be classified as a cause of painful THA and the cemented acetabular component is a feasible option. However, it seems that the osteonecrosis of acetabulum is sparsely alluded in literature. In this case report sustaining of the right hip pain following THA of 35-year-old woman is discussed.

Introduction: Sesamoid bones absorb and disperse weight from the metatarsal bones. Sesamoid injuries occur primarily in dancers and runners, with nonoperative management as the first line of treatment. Due to the lack of secondary blood supply, the sesamoids are at risk for osteonecrosis and nonunion fractures. The literature supporting orthobiologics for the treatment of sesamoid injuries is limited. Methods: In this case, a 28-year-old female dancer with sesamoid osteonecrosis underwent a leukocyte-rich platelet-rich plasma (LR-PRP) injection to the fibular sesamoid. Results: The patient reported significant improvement in pain at the 2-month follow-up and returned to regular auditions at the 3-month follow-up. At 2-year follow-up, the patient\'s symptoms returned to baseline. Conclusion: This is the first known case of sesamoid osteonecrosis treated with LR-PRP. LR-PRP should be considered in the treatment of sesamoid osteonecrosis in those who show limited improvement with standard conservative measures.