Fractures and dislocations: haemochromatosis arthropathy: 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 · Fractures and dislocations: haemochromatosis arthropathy

Sample item

A 52-year-old man with bronzed skin, diabetes and hepatomegaly has pain and stiffness in his hands. Radiographs show hook-like osteophytes and cystic change. Which joints are characteristically affected?

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

The answer and the reasoning

B. Second and third metacarpophalangeal joints

Haemochromatosis arthropathy classically involves the second and third MCP joints, with hook-like osteophytes on the radial side of the metacarpal heads and chondrocalcinosis. It is a degenerative arthropathy that is not reversed by venesection. Rheumatoid arthritis and nodal osteoarthritis spare this pattern.

Option by option

  • A. Distal interphalangeal joints

    DIP involvement with Heberden nodes is the pattern of nodal osteoarthritis.

  • B. Second and third metacarpophalangeal joints (correct)

    Correct. The second and third MCP joints with hook osteophytes are typical.

  • C. First carpometacarpal joint alone

    The first carpometacarpal joint is the usual site of thumb-base osteoarthritis.

  • D. Wrist and proximal interphalangeal joints symmetrically

    Symmetrical wrist and PIP involvement is the pattern of rheumatoid arthritis.

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, Second and third metacarpophalangeal joints. Haemochromatosis arthropathy classically involves the second and third MCP joints, with hook-like osteophytes on the radial side of the metacarpal heads and chondrocalcinosis.

Why is "Distal interphalangeal joints" not the answer?

DIP involvement with Heberden nodes is the pattern of nodal osteoarthritis.

Why is "First carpometacarpal joint alone" not the answer?

The first carpometacarpal joint is the usual site of thumb-base osteoarthritis.

Why is "Wrist and proximal interphalangeal joints symmetrically" not the answer?

Symmetrical wrist and PIP involvement is the pattern of rheumatoid arthritis.

What concept does this question test?

It tests Fractures and dislocations: haemochromatosis arthropathy in Orthopaedics. It is a degenerative arthropathy that is not reversed by venesection. Rheumatoid arthritis and nodal osteoarthritis spare this pattern.

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 Fractures and dislocations: haemochromatosis arthropathy?

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.