Joint pathology: osteoarthritis: practice question

A Pathology 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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Pathology · Joint pathology: osteoarthritis

Sample item

A 65-year-old obese woman has knee pain worse on walking, crepitus and bony enlargement of distal interphalangeal joints. Which findings are expected on examination of the affected knee joint?

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

The answer and the reasoning

B. Eburnated subchondral bone with osteophytes and subchondral cysts

Osteoarthritis begins with chondrocyte-driven breakdown of the cartilage matrix by proteases, with loss of proteoglycans and fibrillation of the surface. Exposed subchondral bone becomes dense and polished (eburnation), and the joint produces osteophytes and subchondral cysts. Synovitis is mild and secondary.

Option by option

  • A. Periarticular osteopenia with marginal erosions and ankylosis

    Periarticular osteopenia with marginal erosions is typical of rheumatoid arthritis.

  • B. Eburnated subchondral bone with osteophytes and subchondral cysts (correct)

    Correct. Eburnation, osteophytes and cysts are the hallmarks.

  • C. Diffuse synovial hyperplasia with villous pannus and lymphoid follicles

    Diffuse villous pannus with lymphoid follicles describes rheumatoid synovium.

  • D. Punched-out erosions with overhanging edges and tophi

    Punched-out erosions with overhanging edges and tophi occur in chronic 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 Pathology question

What is the answer to this Pathology question?

The best answer is B, Eburnated subchondral bone with osteophytes and subchondral cysts. Osteoarthritis begins with chondrocyte-driven breakdown of the cartilage matrix by proteases, with loss of proteoglycans and fibrillation of the surface.

Why is "Periarticular osteopenia with marginal erosions and ankylosis" not the answer?

Periarticular osteopenia with marginal erosions is typical of rheumatoid arthritis.

Why is "Diffuse synovial hyperplasia with villous pannus and lymphoid follicl…" not the answer?

Diffuse villous pannus with lymphoid follicles describes rheumatoid synovium.

Why is "Punched-out erosions with overhanging edges and tophi" not the answer?

Punched-out erosions with overhanging edges and tophi occur in chronic gout.

What concept does this question test?

It tests Joint pathology: osteoarthritis in Pathology. Exposed subchondral bone becomes dense and polished (eburnation), and the joint produces osteophytes and subchondral cysts. Synovitis is mild and secondary.

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 Joint pathology: osteoarthritis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.