Rheumatology: hypertrophic osteoarthropathy: 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: hypertrophic osteoarthropathy

Sample item

A 62-year-old smoker has finger clubbing, painful swollen wrists and ankles, and radiographs showing linear new bone formation along the shafts of the tibia and radius. Which underlying disease should be sought first?

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

The answer and the reasoning

C. Bronchogenic carcinoma

Clubbing with painful joints and periostitis of long bones describes hypertrophic osteoarthropathy. Most often it accompanies lung cancer, and it can regress after the tumour is resected.

Option by option

  • A. Hypothyroidism

    Hypothyroidism may cause arthralgia but not periosteal new bone and clubbing.

  • B. Gout

    Gout causes punched-out erosions with overhanging edges and does not cause periostitis.

  • C. Bronchogenic carcinoma (correct)

    Correct. Periosteal new bone with clubbing in a smoker points to a lung tumour.

  • D. Rheumatoid arthritis

    Rheumatoid arthritis causes erosions and joint space loss without shaft periostitis.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Bronchogenic carcinoma. Clubbing with painful joints and periostitis of long bones describes hypertrophic osteoarthropathy.

Why is "Hypothyroidism" not the answer?

Hypothyroidism may cause arthralgia but not periosteal new bone and clubbing.

Why is "Gout" not the answer?

Gout causes punched-out erosions with overhanging edges and does not cause periostitis.

Why is "Rheumatoid arthritis" not the answer?

Rheumatoid arthritis causes erosions and joint space loss without shaft periostitis.

What concept does this question test?

It tests Rheumatology: hypertrophic osteoarthropathy in General Medicine. Most often it accompanies lung cancer, and it can regress after the tumour is resected.

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 Rheumatology: hypertrophic osteoarthropathy?

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.