Bone and joint infections: spine-at-risk signs in children: 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.

Try it

Orthopaedics · Bone and joint infections: spine-at-risk signs in children

Sample item

A 5-year-old has dorsal spine tuberculosis with 25 degrees of kyphosis at presentation. Which radiographic sign indicates a spine at risk of severe progressive kyphosis during growth?

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

The answer and the reasoning

B. Toppling sign

In children with spinal tuberculosis, four signs mark a spine at risk: separation of the facet joints, posterior retropulsion, lateral translation and the toppling sign (a radiographic alignment sign of instability at the diseased segment). Such children may need early surgery to prevent severe deformity.

Option by option

  • A. Sclerosis of the adjacent vertebral bodies

    Sclerosis suggests healing and does not predict collapse.

  • B. Toppling sign (correct)

    Correct. This is one of the radiographic signs of instability that predict progressive kyphosis.

  • C. Scalloping of the anterior vertebral margin

    Anterior scalloping reflects pressure erosion by an aneurysm or abscess, not instability.

  • D. Calcification of the paravertebral abscess

    Abscess calcification indicates chronicity and is not a predictor of deformity progression.

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 Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Toppling sign. In children with spinal tuberculosis, four signs mark a spine at risk: separation of the facet joints, posterior retropulsion, lateral translation and the toppling sign (a radiographic alignment sign of instability at the diseased segment).

Why is "Sclerosis of the adjacent vertebral bodies" not the answer?

Sclerosis suggests healing and does not predict collapse.

Why is "Scalloping of the anterior vertebral margin" not the answer?

Anterior scalloping reflects pressure erosion by an aneurysm or abscess, not instability.

Why is "Calcification of the paravertebral abscess" not the answer?

Abscess calcification indicates chronicity and is not a predictor of deformity progression.

What concept does this question test?

It tests Bone and joint infections: spine-at-risk signs in children in Orthopaedics. Such children may need early surgery to prevent severe deformity.

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: spine-at-risk signs in children?

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.