Musculoskeletal imaging: haemophilic arthropathy: practice question

A Radiology 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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Radiology · Musculoskeletal imaging: haemophilic arthropathy

Sample item

A 12-year-old boy with prolonged bleeding after dental extraction has recurrent bloody knee effusions. Radiographs show a widened intercondylar notch, a squared inferior patella, enlarged epiphyses and subchondral cysts. What is the diagnosis?

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

The answer and the reasoning

B. Haemophilic arthropathy

Repeated haemarthrosis causes synovial hyperaemia and haemosiderin deposition, leading to epiphyseal overgrowth, a widened intercondylar notch, a squared patella and subchondral cysts. A bleeding history and bloody aspirates separate it from juvenile arthritis, which shows similar overgrowth.

Option by option

  • A. Tuberculous arthritis

    Tuberculous arthritis causes the Phemister triad of osteopenia, peripheral erosions and narrowing, with a late-appearing joint space loss.

  • B. Haemophilic arthropathy (correct)

    Correct. A bleeding diathesis with bloody effusions and epiphyseal overgrowth with a widened notch indicates haemophilic arthropathy.

  • C. Juvenile idiopathic arthritis

    Juvenile idiopathic arthritis shows similar overgrowth but with non-bloody synovitis and no bleeding history.

  • D. Pigmented villonodular synovitis

    Pigmented villonodular synovitis is usually monoarticular in adults, with synovial masses and erosions, and normal bone density.

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 Radiology question

What is the answer to this Radiology question?

The best answer is B, Haemophilic arthropathy. Repeated haemarthrosis causes synovial hyperaemia and haemosiderin deposition, leading to epiphyseal overgrowth, a widened intercondylar notch, a squared patella and subchondral cysts.

Why is "Tuberculous arthritis" not the answer?

Tuberculous arthritis causes the Phemister triad of osteopenia, peripheral erosions and narrowing, with a late-appearing joint space loss.

Why is "Juvenile idiopathic arthritis" not the answer?

Juvenile idiopathic arthritis shows similar overgrowth but with non-bloody synovitis and no bleeding history.

Why is "Pigmented villonodular synovitis" not the answer?

Pigmented villonodular synovitis is usually monoarticular in adults, with synovial masses and erosions, and normal bone density.

What concept does this question test?

It tests Musculoskeletal imaging: haemophilic arthropathy in Radiology. A bleeding history and bloody aspirates separate it from juvenile arthritis, which shows similar overgrowth.

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 Musculoskeletal imaging: haemophilic arthropathy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.