Bone and joint infection: 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 · Bone and joint infection

Sample item

A child has chronic knee swelling, quadriceps wasting and little pain. Radiographs show periarticular osteoporosis, erosion of the joint margins and gradual narrowing of the joint space. Which condition is this?

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

The answer and the reasoning

A. Tuberculous arthritis

Phemister's triad of tuberculous arthritis comprises juxta-articular osteoporosis, peripheral erosions and gradual narrowing of the joint space. The course is indolent compared with pyogenic arthritis, and the synovium is thickened with wasting of nearby muscles.

Option by option

  • A. Tuberculous arthritis (correct)

    The triad of osteoporosis, marginal erosions and gradual space narrowing is Phemister's triad of tuberculosis.

  • B. Gouty arthritis

    Gout gives punched-out erosions with overhanging edges and occurs in adults.

  • C. Osteoarthritis

    Osteoarthritis gives osteophytes and subchondral sclerosis in older adults.

  • D. Acute pyogenic arthritis

    Acute pyogenic arthritis is rapid, painful and febrile, with fast destruction of the joint space.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Tuberculous arthritis. Phemister's triad of tuberculous arthritis comprises juxta-articular osteoporosis, peripheral erosions and gradual narrowing of the joint space.

Why is "Gouty arthritis" not the answer?

Gout gives punched-out erosions with overhanging edges and occurs in adults.

Why is "Osteoarthritis" not the answer?

Osteoarthritis gives osteophytes and subchondral sclerosis in older adults.

Why is "Acute pyogenic arthritis" not the answer?

Acute pyogenic arthritis is rapid, painful and febrile, with fast destruction of the joint space.

What concept does this question test?

It tests Bone and joint infection in Orthopaedics. The course is indolent compared with pyogenic arthritis, and the synovium is thickened with wasting of nearby muscles.

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 Bone and joint infection?

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.