Paediatric knee: 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 knee

Sample item

A 13-year-old athletic boy has pain and a tender bony prominence over the tibial tubercle, aggravated by running and kneeling, which is relieved by rest. The radiograph shows fragmentation of the tubercle. What is the diagnosis and the usual management?

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

The answer and the reasoning

C. Osgood-Schlatter disease, managed by activity modification and analgesia

Osgood-Schlatter disease is a traction apophysitis of the tibial tubercle in growing adolescents who are physically active, from repetitive pull of the quadriceps through the patellar tendon. It is self-limiting and treated by activity reduction, stretching and analgesics until the physis closes.

Option by option

  • A. Patellar tendon rupture, managed by repair

    A patellar tendon rupture causes inability to extend the knee after trauma.

  • B. Osteochondritis dissecans, managed by cast

    Osteochondritis dissecans involves the femoral condyle with a loose fragment.

  • C. Osgood-Schlatter disease, managed by activity modification and analgesia (correct)

    Correct. A tender tibial tubercle in an active adolescent is typical, and the management is conservative.

  • D. Sinding-Larsen-Johansson disease, managed by surgery

    Sinding-Larsen-Johansson disease involves the lower pole of the patella.

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 C, Osgood-Schlatter disease, managed by activity modification and analgesia. Osgood-Schlatter disease is a traction apophysitis of the tibial tubercle in growing adolescents who are physically active, from repetitive pull of the quadriceps through the patellar tendon.

Why is "Patellar tendon rupture, managed by repair" not the answer?

A patellar tendon rupture causes inability to extend the knee after trauma.

Why is "Osteochondritis dissecans, managed by cast" not the answer?

Osteochondritis dissecans involves the femoral condyle with a loose fragment.

Why is "Sinding-Larsen-Johansson disease, managed by surgery" not the answer?

Sinding-Larsen-Johansson disease involves the lower pole of the patella.

What concept does this question test?

It tests Paediatric knee in Orthopaedics. It is self-limiting and treated by activity reduction, stretching and analgesics until the physis closes.

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 Paediatric knee?

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.