Bone tumours: hypertrophic osteoarthropathy: 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 · Bone tumours: hypertrophic osteoarthropathy

Sample item

A 62-year-old smoker has digital clubbing, painful swollen wrists and ankles, and periosteal new bone along the distal tibia and radius on radiographs. Which condition should be suspected?

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

The answer and the reasoning

A. Hypertrophic osteoarthropathy secondary to bronchogenic carcinoma

Hypertrophic osteoarthropathy is the triad of digital clubbing, periostitis of long bones and arthritis. It is most often secondary to lung cancer and other thoracic disease, and may resolve when the cause is treated. A chest imaging study is the next step.

Option by option

  • A. Hypertrophic osteoarthropathy secondary to bronchogenic carcinoma (correct)

    Correct. Clubbing with periostitis and arthropathy in a smoker suggests lung cancer.

  • B. Rheumatoid arthritis

    Rheumatoid arthritis causes erosions and symmetrical synovitis, not clubbing with periostitis.

  • C. Osteomyelitis

    Osteomyelitis is a localised infection and does not cause symmetrical periostitis with clubbing.

  • D. Psoriatic arthritis

    Psoriatic arthritis causes dactylitis and pencil-in-cup changes.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Hypertrophic osteoarthropathy secondary to bronchogenic carcinoma. Hypertrophic osteoarthropathy is the triad of digital clubbing, periostitis of long bones and arthritis.

Why is "Rheumatoid arthritis" not the answer?

Rheumatoid arthritis causes erosions and symmetrical synovitis, not clubbing with periostitis.

Why is "Osteomyelitis" not the answer?

Osteomyelitis is a localised infection and does not cause symmetrical periostitis with clubbing.

Why is "Psoriatic arthritis" not the answer?

Psoriatic arthritis causes dactylitis and pencil-in-cup changes.

What concept does this question test?

It tests Bone tumours: hypertrophic osteoarthropathy in Orthopaedics. It is most often secondary to lung cancer and other thoracic disease, and may resolve when the cause is treated. A chest imaging study is the next step.

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 Bone tumours: hypertrophic osteoarthropathy?

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.