Paediatric orthopaedics: 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 · Paediatric orthopaedics

Sample item

A 6-year-old boy has a limp and vague knee pain for several weeks without fever. Hip abduction and internal rotation are limited, and the radiograph shows a small, dense, flattened femoral head. What is the diagnosis?

ATransient synovitis of the hipBSlipped capital femoral epiphysisCSeptic arthritis of the hipDPerthes disease

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

The answer and the reasoning

D. Perthes disease

Legg-Calve-Perthes disease is idiopathic avascular necrosis of the femoral capital epiphysis in children, mostly boys aged 4 to 8 years. Pain may be referred to the knee, and radiographs show a dense, fragmented or flattened head.

Option by option

A. Transient synovitis of the hip
Transient synovitis is short-lived and has a normal radiograph.
B. Slipped capital femoral epiphysis
Slipped epiphysis typically affects obese adolescents rather than a child of 6.
C. Septic arthritis of the hip
Septic arthritis presents with fever, severe pain and an irritable hip over a short time.
D. Perthes disease (correct)
A child with a persistent limp, restricted motion and a dense flattened femoral head has Perthes disease.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Perthes disease. Legg-Calve-Perthes disease is idiopathic avascular necrosis of the femoral capital epiphysis in children, mostly boys aged 4 to 8 years.

Why is "Transient synovitis of the hip" not the answer?

Transient synovitis is short-lived and has a normal radiograph.

Why is "Slipped capital femoral epiphysis" not the answer?

Slipped epiphysis typically affects obese adolescents rather than a child of 6.

Why is "Septic arthritis of the hip" not the answer?

Septic arthritis presents with fever, severe pain and an irritable hip over a short time.

What concept does this question test?

It tests Paediatric orthopaedics in Orthopaedics. Pain may be referred to the knee, and radiographs show a dense, fragmented or flattened head.

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 Paediatric orthopaedics?

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.