Bone and joint infections: cause of early-onset Pott paraplegia: 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 · Bone and joint infections: cause of early-onset Pott paraplegia

Sample item

A 24-year-old with active dorsal spine tuberculosis develops paraparesis over three weeks. MRI shows a large paravertebral abscess and no healed bony ridge. What is the most likely cause of cord compression?

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

The answer and the reasoning

D. Abscess, granulation tissue and caseous debris

Paraplegia during active disease is caused by inflammatory compression from pus, granulation tissue, caseous material or sequestra, and it usually has the best outlook with chemotherapy and, if needed, decompression. Bony ridges, dural fibrosis and syrinx belong to late-onset paraplegia after healing.

Option by option

  • A. Cord stretched over an internal bony gibbus

    Stretching over an internal gibbus causes late-onset paraplegia after the disease has healed.

  • B. Post-healing syringomyelia

    Syringomyelia develops years after the original infection.

  • C. Dural fibrosis after healing

    Dural fibrosis is a late cause in healed disease.

  • D. Abscess, granulation tissue and caseous debris (correct)

    Correct. Soft inflammatory material compresses the cord in the active phase and is potentially reversible.

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 D, Abscess, granulation tissue and caseous debris. Paraplegia during active disease is caused by inflammatory compression from pus, granulation tissue, caseous material or sequestra, and it usually has the best outlook with chemotherapy and, if needed, decompression.

Why is "Cord stretched over an internal bony gibbus" not the answer?

Stretching over an internal gibbus causes late-onset paraplegia after the disease has healed.

Why is "Post-healing syringomyelia" not the answer?

Syringomyelia develops years after the original infection.

Why is "Dural fibrosis after healing" not the answer?

Dural fibrosis is a late cause in healed disease.

What concept does this question test?

It tests Bone and joint infections: cause of early-onset Pott paraplegia in Orthopaedics. Bony ridges, dural fibrosis and syrinx belong to late-onset paraplegia after healing.

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 Bone and joint infections: cause of early-onset Pott paraplegia?

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.