Joint infection: neonatal septic hip: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Joint infection: neonatal septic hip

Sample item

A 10-day-old premature baby, who had a central line, lies with the right leg flexed, abducted and externally rotated and does not move it. There is little fever. What is the most important clinical point?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Pseudoparalysis from a septic hip may occur without fever, so urgent ultrasound and aspiration are needed

Neonatal septic arthritis often lacks fever and toxicity. Pseudoparalysis, with the hip held flexed, abducted and externally rotated, is the main sign. Urgent ultrasound, aspiration and surgical drainage are needed to prevent destruction of the femoral head.

Option by option

  • A. Pseudoparalysis from a septic hip may occur without fever, so urgent ultrasound and aspiration are needed (correct)

    Correct. Pseudoparalysis without fever is typical, and early drainage saves the joint.

  • B. Fever is always present in neonatal septic arthritis

    Neonates frequently have no fever, so its absence is misleading.

  • C. A normal white count excludes infection

    Inflammatory markers can be normal in neonates and do not exclude infection.

  • D. Immobilisation in a cast and observation is sufficient

    Observation risks rapid joint destruction and avascular necrosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Pseudoparalysis from a septic hip may occur without fever, so urgent ultrasound and aspiration are needed. Neonatal septic arthritis often lacks fever and toxicity.

Why is "Fever is always present in neonatal septic arthritis" not the answer?

Neonates frequently have no fever, so its absence is misleading.

Why is "A normal white count excludes infection" not the answer?

Inflammatory markers can be normal in neonates and do not exclude infection.

Why is "Immobilisation in a cast and observation is sufficient" not the answer?

Observation risks rapid joint destruction and avascular necrosis.

What concept does this question test?

It tests Joint infection: neonatal septic hip in Orthopaedics. Pseudoparalysis, with the hip held flexed, abducted and externally rotated, is the main sign. Urgent ultrasound, aspiration and surgical drainage are needed to prevent destruction of the femoral head.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Joint infection: neonatal septic hip?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.