Rheumatology: eosinophilic fasciitis: practice question

A General Medicine 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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General Medicine · Rheumatology: eosinophilic fasciitis

Sample item

A 35-year-old man develops painful swelling and then woody induration of the forearms and legs with a peau d'orange appearance a week after strenuous exercise. His hands and face are spared, there is no Raynaud phenomenon, and blood tests show eosinophilia and a raised ESR. Which diagnosis is most likely?

AEosinophilic fasciitisBDiffuse systemic sclerosisCDermatomyositisDMorphea

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

The answer and the reasoning

A. Eosinophilic fasciitis

Eosinophilic fasciitis presents abruptly with symmetrical induration of the limbs and trunk, often after exertion, sparing the hands and face. It has no Raynaud phenomenon, but there is peripheral eosinophilia and thickened fascia on MRI or deep biopsy. It responds to corticosteroids.

Option by option

A. Eosinophilic fasciitis (correct)
Correct. Sudden woody limb induration after exertion with sparing of hands, no Raynaud and eosinophilia are typical.
B. Diffuse systemic sclerosis
Systemic sclerosis causes Raynaud phenomenon, sclerodactyly and facial involvement.
C. Dermatomyositis
Dermatomyositis causes proximal weakness with a heliotrope rash and Gottron papules.
D. Morphea
Morphea gives localised patches of skin sclerosis rather than diffuse limb induration.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Eosinophilic fasciitis. Eosinophilic fasciitis presents abruptly with symmetrical induration of the limbs and trunk, often after exertion, sparing the hands and face.

Why is "Diffuse systemic sclerosis" not the answer?

Systemic sclerosis causes Raynaud phenomenon, sclerodactyly and facial involvement.

Why is "Dermatomyositis" not the answer?

Dermatomyositis causes proximal weakness with a heliotrope rash and Gottron papules.

Why is "Morphea" not the answer?

Morphea gives localised patches of skin sclerosis rather than diffuse limb induration.

What concept does this question test?

It tests Rheumatology: eosinophilic fasciitis in General Medicine. It has no Raynaud phenomenon, but there is peripheral eosinophilia and thickened fascia on MRI or deep biopsy. It responds to corticosteroids.

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 Rheumatology: eosinophilic fasciitis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.