Papulosquamous disorders: radiology of arthritis mutilans: practice question

A Dermatology 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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Dermatology · Papulosquamous disorders: radiology of arthritis mutilans

Sample item

A patient with long-standing severe psoriasis has shortened, telescoping fingers. Radiographs show erosion of the proximal phalanx into a cup-shaped end with the distal bone tapered like a pencil. What is this pattern?

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

The answer and the reasoning

A. Arthritis mutilans

Arthritis mutilans is the most destructive pattern of psoriatic arthritis, with bone resorption giving the pencil-in-cup deformity and telescoping digits. It is usually seen with severe skin and nail disease and needs early biologic therapy.

Option by option

  • A. Arthritis mutilans (correct)

    Correct. Pencil-in-cup deformity with telescoping digits is the hallmark of arthritis mutilans.

  • B. Osteoarthritis with osteophytes

    Osteoarthritis shows narrowing and osteophytes, not destructive resorption.

  • C. Rheumatoid arthritis of the hand

    Rheumatoid arthritis causes symmetric MCP and PIP erosions, with periarticular osteopenia.

  • D. Gouty tophaceous erosion

    Gout gives punched-out erosions with overhanging edges, not a pencil-in-cup picture.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Arthritis mutilans. Arthritis mutilans is the most destructive pattern of psoriatic arthritis, with bone resorption giving the pencil-in-cup deformity and telescoping digits.

Why is "Osteoarthritis with osteophytes" not the answer?

Osteoarthritis shows narrowing and osteophytes, not destructive resorption.

Why is "Rheumatoid arthritis of the hand" not the answer?

Rheumatoid arthritis causes symmetric MCP and PIP erosions, with periarticular osteopenia.

Why is "Gouty tophaceous erosion" not the answer?

Gout gives punched-out erosions with overhanging edges, not a pencil-in-cup picture.

What concept does this question test?

It tests Papulosquamous disorders: radiology of arthritis mutilans in Dermatology. It is usually seen with severe skin and nail disease and needs early biologic therapy.

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 Papulosquamous disorders: radiology of arthritis mutilans?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology 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.