MSK imaging: gout: 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 · MSK imaging: gout

Sample item

A man with recurrent acute first MTP joint pain has radiographs showing 'punched-out' erosions with overhanging edges and a preserved joint space, with soft tissue swellings. What is the diagnosis?

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

The answer and the reasoning

D. Chronic tophaceous gout

Gouty erosions are juxta-articular, well-defined with sclerotic and overhanging margins, with a late loss of joint space and periarticular bone density is preserved. Tophi may calcify. Dual-energy CT can show urate deposits.

Option by option

  • A. Osteoarthritis

    Osteoarthritis shows osteophytes and sclerosis.

  • B. Septic arthritis

    Septic arthritis shows rapid joint space loss and destruction.

  • C. Rheumatoid arthritis

    RA shows marginal erosions with periarticular osteopenia.

  • D. Chronic tophaceous gout (correct)

    Correct. Punched-out erosions with overhanging edges and preserved density suggest gout.

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 D, Chronic tophaceous gout. Gouty erosions are juxta-articular, well-defined with sclerotic and overhanging margins, with a late loss of joint space and periarticular bone density is preserved.

Why is "Osteoarthritis" not the answer?

Osteoarthritis shows osteophytes and sclerosis.

Why is "Septic arthritis" not the answer?

Septic arthritis shows rapid joint space loss and destruction.

Why is "Rheumatoid arthritis" not the answer?

RA shows marginal erosions with periarticular osteopenia.

What concept does this question test?

It tests MSK imaging: gout in Radiology. Tophi may calcify. Dual-energy CT can show urate deposits.

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 MSK imaging: gout?

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.