Paediatric orthopaedics: chondrolysis after SCFE: 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 · Paediatric orthopaedics: chondrolysis after SCFE

Sample item

A 13-year-old boy underwent in situ pinning for a slipped capital femoral epiphysis. Three months later he has increasing hip pain and stiffness, with radiographs showing joint space narrowing to less than 3 mm and no avascular necrosis. What is the likely complication?

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

The answer and the reasoning

B. Chondrolysis, possibly from a screw penetrating the joint

Chondrolysis is acute cartilage necrosis with joint space narrowing, pain and stiffness, and it may follow SCFE, particularly with pin penetration into the joint. Careful fluoroscopic placement of the screw within the femoral head avoids this. Treatment is supportive with physiotherapy and anti-inflammatory drugs.

Option by option

  • A. Septic arthritis only

    Septic arthritis would show fever and raised inflammatory markers, although it should be excluded.

  • B. Chondrolysis, possibly from a screw penetrating the joint (correct)

    Correct. Joint space narrowing and stiffness after SCFE fixation suggests chondrolysis.

  • C. Perthes disease

    Perthes disease is a primary idiopathic condition of younger children.

  • D. Transient synovitis

    Transient synovitis is a short self-limiting illness in younger children.

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 B, Chondrolysis, possibly from a screw penetrating the joint. Chondrolysis is acute cartilage necrosis with joint space narrowing, pain and stiffness, and it may follow SCFE, particularly with pin penetration into the joint.

Why is "Septic arthritis only" not the answer?

Septic arthritis would show fever and raised inflammatory markers, although it should be excluded.

Why is "Perthes disease" not the answer?

Perthes disease is a primary idiopathic condition of younger children.

Why is "Transient synovitis" not the answer?

Transient synovitis is a short self-limiting illness in younger children.

What concept does this question test?

It tests Paediatric orthopaedics: chondrolysis after SCFE in Orthopaedics. Careful fluoroscopic placement of the screw within the femoral head avoids this. Treatment is supportive with physiotherapy and anti-inflammatory drugs.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Paediatric orthopaedics: chondrolysis after SCFE?

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.