Systemic paediatrics: infantile Blount disease: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: infantile Blount disease

Sample item

An obese 3-year-old who walked at 10 months has progressive bowing of both legs that is worsening rather than correcting. The radiograph shows sharp varus angulation with beaking of the medial proximal tibial metaphysis. Which condition is this?

AInfantile Blount diseaseBNutritional ricketsCCongenital pseudarthrosis of the tibiaDPhysiological genu varum

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

The answer and the reasoning

A. Infantile Blount disease

Blount disease is a growth disorder of the medial proximal tibial physis, associated with obesity and early walking. Bowing worsens after age 2 and shows metaphyseal beaking. Physiological bowing is symmetrical, improves with age and has a normal physis.

Option by option

A. Infantile Blount disease (correct)
Correct. Progressive varus with medial tibial metaphyseal beaking in an obese early walker indicates Blount disease.
B. Nutritional rickets
Rickets shows cupped, frayed metaphyses and biochemical abnormalities, not focal beaking.
C. Congenital pseudarthrosis of the tibia
Congenital pseudarthrosis of the tibia causes anterolateral bowing, often with neurofibromatosis.
D. Physiological genu varum
Physiological genu varum improves by 2 to 3 years and lacks metaphyseal beaking.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Infantile Blount disease. Blount disease is a growth disorder of the medial proximal tibial physis, associated with obesity and early walking.

Why is "Nutritional rickets" not the answer?

Rickets shows cupped, frayed metaphyses and biochemical abnormalities, not focal beaking.

Why is "Congenital pseudarthrosis of the tibia" not the answer?

Congenital pseudarthrosis of the tibia causes anterolateral bowing, often with neurofibromatosis.

Why is "Physiological genu varum" not the answer?

Physiological genu varum improves by 2 to 3 years and lacks metaphyseal beaking.

What concept does this question test?

It tests Systemic paediatrics: infantile Blount disease in Pediatrics. Bowing worsens after age 2 and shows metaphyseal beaking. Physiological bowing is symmetrical, improves with age and has a normal physis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Systemic paediatrics: infantile Blount disease?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.