Inflammatory arthritis: 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 · Inflammatory arthritis

Sample item

A 22-year-old man has chronic low back pain with morning stiffness that improves with exercise and not with rest. Which radiographic finding is usually the earliest?

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

The answer and the reasoning

C. Bilateral sacroiliitis

In ankylosing spondylitis, usually associated with HLA-B27, inflammation begins at the sacroiliac joints, so bilateral sacroiliitis is the earliest radiographic sign. Bamboo spine and the dagger sign develop later as ligaments ossify. Atlantoaxial subluxation is more a feature of rheumatoid arthritis.

Option by option

  • A. Bamboo spine

    Bamboo spine reflects advanced syndesmophyte fusion.

  • B. Atlantoaxial subluxation

    Atlantoaxial subluxation is typically a complication of rheumatoid arthritis.

  • C. Bilateral sacroiliitis (correct)

    Correct. Sacroiliac involvement comes first.

  • D. Dagger sign

    The dagger sign reflects late ossification of the interspinous ligament.

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 Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Bilateral sacroiliitis. In ankylosing spondylitis, usually associated with HLA-B27, inflammation begins at the sacroiliac joints, so bilateral sacroiliitis is the earliest radiographic sign.

Why is "Bamboo spine" not the answer?

Bamboo spine reflects advanced syndesmophyte fusion.

Why is "Atlantoaxial subluxation" not the answer?

Atlantoaxial subluxation is typically a complication of rheumatoid arthritis.

Why is "Dagger sign" not the answer?

The dagger sign reflects late ossification of the interspinous ligament.

What concept does this question test?

It tests Inflammatory arthritis in Orthopaedics. Bamboo spine and the dagger sign develop later as ligaments ossify. Atlantoaxial subluxation is more a feature of rheumatoid arthritis.

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 Inflammatory arthritis?

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.