Paediatric orthopaedics: hemihypertrophy and tumour screening: 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 · Paediatric orthopaedics: hemihypertrophy and tumour screening

Sample item

A 4-year-old has isolated hemihypertrophy of the right leg with a limb-length discrepancy. Which surveillance is recommended in this child?

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

The answer and the reasoning

B. Serial abdominal ultrasound for embryonal tumours

Isolated hemihypertrophy and overgrowth syndromes such as Beckwith-Wiedemann syndrome carry a risk of embryonal tumours, especially Wilms tumour and hepatoblastoma, so regular abdominal ultrasound is advised in early childhood in addition to orthopaedic management of the discrepancy.

Option by option

  • A. Serial thyroid function tests

    Thyroid dysfunction is not linked with this overgrowth.

  • B. Serial abdominal ultrasound for embryonal tumours (correct)

    Correct. Wilms tumour and hepatoblastoma are the recognised risks.

  • C. Annual echocardiography

    Echocardiography is not a recognised screening need in isolated hemihypertrophy.

  • D. Repeat skeletal survey for fractures

    Fractures are not the concern in overgrowth, which is not a bone fragility condition.

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, Serial abdominal ultrasound for embryonal tumours. Isolated hemihypertrophy and overgrowth syndromes such as Beckwith-Wiedemann syndrome carry a risk of embryonal tumours, especially Wilms tumour and hepatoblastoma, so regular abdominal ultrasound is advised in early childhood in addition to orthopaedic management of the discrepancy.

Why is "Serial thyroid function tests" not the answer?

Thyroid dysfunction is not linked with this overgrowth.

Why is "Annual echocardiography" not the answer?

Echocardiography is not a recognised screening need in isolated hemihypertrophy.

Why is "Repeat skeletal survey for fractures" not the answer?

Fractures are not the concern in overgrowth, which is not a bone fragility condition.

What concept does this question test?

It tests Paediatric orthopaedics: hemihypertrophy and tumour screening in Orthopaedics. The correct option holds because: Correct. Wilms tumour and hepatoblastoma are the recognised risks.

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 Paediatric orthopaedics: hemihypertrophy and tumour screening?

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.