Bone and joint infections: intracapsular metaphysis: 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: intracapsular metaphysis

Sample item

In an infant with metaphyseal osteomyelitis, pus can rupture directly into the neighbouring joint only when the metaphysis lies inside the joint capsule. In which of these bones does this occur?

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

The answer and the reasoning

B. Proximal femur

The capsule of the hip attaches at the base of the femoral neck, so the proximal femoral metaphysis is intracapsular and osteomyelitis there readily causes septic arthritis. The proximal radius is also intracapsular. In the distal femur, proximal tibia and distal radius the metaphysis is extracapsular.

Option by option

  • A. Proximal tibia

    The proximal tibial metaphysis lies outside the knee capsule.

  • B. Proximal femur (correct)

    Correct. The femoral neck metaphysis is within the hip capsule.

  • C. Distal radius

    The capsule of the wrist attaches near the articular margin, leaving the metaphysis outside.

  • D. Distal femur

    The distal femoral metaphysis lies outside the knee capsule.

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 B, Proximal femur. The capsule of the hip attaches at the base of the femoral neck, so the proximal femoral metaphysis is intracapsular and osteomyelitis there readily causes septic arthritis.

Why is "Proximal tibia" not the answer?

The proximal tibial metaphysis lies outside the knee capsule.

Why is "Distal radius" not the answer?

The capsule of the wrist attaches near the articular margin, leaving the metaphysis outside.

Why is "Distal femur" not the answer?

The distal femoral metaphysis lies outside the knee capsule.

What concept does this question test?

It tests Bone and joint infections: intracapsular metaphysis in Orthopaedics. The proximal radius is also intracapsular. In the distal femur, proximal tibia and distal radius the metaphysis is extracapsular.

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: intracapsular metaphysis?

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.