Musculoskeletal imaging: psoriatic arthritis: 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.

Try it

Radiology · Musculoskeletal imaging: psoriatic arthritis

Sample item

A 45-year-old man with scaly skin plaques and a sausage-shaped finger has hand radiographs showing distal interphalangeal joint erosions, a tapered phalangeal head with cup-shaped widening of the adjacent base, and fluffy periostitis. Which diagnosis fits best?

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

The answer and the reasoning

B. Psoriatic arthritis

Psoriatic arthritis favours the distal interphalangeal joints and combines erosion with new bone formation, giving the pencil-in-cup deformity and fluffy periostitis. Bone density is usually preserved.

Option by option

  • A. Gout

    Gout produces punched-out erosions with overhanging edges and a preserved joint space, without pencil-in-cup change.

  • B. Psoriatic arthritis (correct)

    Correct. DIP erosions with proliferative new bone, periostitis and a pencil-in-cup deformity point to psoriatic arthritis.

  • C. Rheumatoid arthritis

    Rheumatoid arthritis causes marginal erosions with periarticular osteopenia and favours MCP and PIP joints, without periostitis.

  • D. Erosive osteoarthritis

    Erosive osteoarthritis produces central erosions with a gull-wing pattern and no periostitis.

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 Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Psoriatic arthritis. Psoriatic arthritis favours the distal interphalangeal joints and combines erosion with new bone formation, giving the pencil-in-cup deformity and fluffy periostitis.

Why is "Gout" not the answer?

Gout produces punched-out erosions with overhanging edges and a preserved joint space, without pencil-in-cup change.

Why is "Rheumatoid arthritis" not the answer?

Rheumatoid arthritis causes marginal erosions with periarticular osteopenia and favours MCP and PIP joints, without periostitis.

Why is "Erosive osteoarthritis" not the answer?

Erosive osteoarthritis produces central erosions with a gull-wing pattern and no periostitis.

What concept does this question test?

It tests Musculoskeletal imaging: psoriatic arthritis in Radiology. Bone density is usually preserved.

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 Musculoskeletal imaging: psoriatic arthritis?

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.