Vascular surgery: acute Charcot neuro-osteoarthropathy: practice question

A General Surgery 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 Surgery · Vascular surgery: acute Charcot neuro-osteoarthropathy

Sample item

A diabetic man with peripheral neuropathy has a warm, red, swollen foot for two weeks without any ulcer. Pulses are palpable, inflammatory markers are only mildly raised, and radiographs show fragmentation of the midfoot bones. What is the best initial treatment?

AEarly mobilisation in cushioned shoesBSix weeks of intravenous antibiotics for osteomyelitisCImmobilisation in a non-weight-bearing total contact castDFemoropopliteal bypass to improve perfusion

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

The answer and the reasoning

C. Immobilisation in a non-weight-bearing total contact cast

In acute Charcot foot, neuropathy and repetitive trauma cause bone and joint destruction in a warm, swollen foot with intact skin. Offloading and immobilisation in a total contact cast until temperature difference and swelling settle prevents collapse and later ulceration.

Option by option

A. Early mobilisation in cushioned shoes
Continued weight-bearing speeds collapse of the midfoot arch and ulceration.
B. Six weeks of intravenous antibiotics for osteomyelitis
With intact skin, palpable pulses and mildly raised markers, osteomyelitis is unlikely and antibiotics are not indicated.
C. Immobilisation in a non-weight-bearing total contact cast (correct)
Correct. Offloading with total contact casting protects the foot while the bones heal.
D. Femoropopliteal bypass to improve perfusion
Pulses are palpable, so ischaemia is not the cause and bypass will not help.

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 Surgery question

What is the answer to this General Surgery question?

The best answer is C, Immobilisation in a non-weight-bearing total contact cast. In acute Charcot foot, neuropathy and repetitive trauma cause bone and joint destruction in a warm, swollen foot with intact skin.

Why is "Early mobilisation in cushioned shoes" not the answer?

Continued weight-bearing speeds collapse of the midfoot arch and ulceration.

Why is "Six weeks of intravenous antibiotics for osteomyelitis" not the answer?

With intact skin, palpable pulses and mildly raised markers, osteomyelitis is unlikely and antibiotics are not indicated.

Why is "Femoropopliteal bypass to improve perfusion" not the answer?

Pulses are palpable, so ischaemia is not the cause and bypass will not help.

What concept does this question test?

It tests Vascular surgery: acute Charcot neuro-osteoarthropathy in General Surgery. Offloading and immobilisation in a total contact cast until temperature difference and swelling settle prevents collapse and later ulceration.

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 Vascular surgery: acute Charcot neuro-osteoarthropathy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.