Musculoskeletal imaging: tuberculous arthritis: practice question

A Radiology 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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Radiology · Musculoskeletal imaging: tuberculous arthritis

Sample item

A child from a rural area has months of knee swelling, night pain, low-grade fever and wasting of the thigh. A radiograph shows periarticular osteopenia, peripheral erosions and a joint space that narrows only slowly. What is the diagnosis?

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

The answer and the reasoning

B. Tuberculous arthritis

The Phemister triad of tuberculous arthritis is juxta-articular osteopenia, peripheral osseous erosions and gradual narrowing of the joint space, because the organism lacks proteolytic enzymes and cartilage is lost late. Pyogenic arthritis destroys cartilage rapidly. Haemophilic arthropathy shows dense effusion and epiphyseal overgrowth.

Option by option

  • A. Haemophilic arthropathy

    Haemophilic arthropathy follows recurrent bleeding with epiphyseal enlargement.

  • B. Tuberculous arthritis (correct)

    Correct. The Phemister triad with constitutional symptoms points to tuberculosis.

  • C. Pyogenic arthritis

    Pyogenic arthritis gives rapid joint space loss and acute toxicity.

  • D. Juvenile idiopathic arthritis

    Juvenile idiopathic arthritis causes a more uniform loss of space and no wasting with night pain.

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 Radiology question

What is the answer to this Radiology question?

The best answer is B, Tuberculous arthritis. The Phemister triad of tuberculous arthritis is juxta-articular osteopenia, peripheral osseous erosions and gradual narrowing of the joint space, because the organism lacks proteolytic enzymes and cartilage is lost late.

Why is "Haemophilic arthropathy" not the answer?

Haemophilic arthropathy follows recurrent bleeding with epiphyseal enlargement.

Why is "Pyogenic arthritis" not the answer?

Pyogenic arthritis gives rapid joint space loss and acute toxicity.

Why is "Juvenile idiopathic arthritis" not the answer?

Juvenile idiopathic arthritis causes a more uniform loss of space and no wasting with night pain.

What concept does this question test?

It tests Musculoskeletal imaging: tuberculous arthritis in Radiology. Pyogenic arthritis destroys cartilage rapidly. Haemophilic arthropathy shows dense effusion and epiphyseal overgrowth.

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 Musculoskeletal imaging: tuberculous arthritis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.