Bone infection: early tuberculosis of the hip posture: 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 infection: early tuberculosis of the hip posture

Sample item

A 7-year-old has had a limp and night cries for three months. The right hip lies flexed, abducted and externally rotated. What is the apparent limb length finding?

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

The answer and the reasoning

D. Apparent lengthening of the limb

In the early stage of tuberculous synovitis the hip is held flexed, abducted and externally rotated. Abduction tilts the pelvis down on that side, so the limb looks longer than the other, giving apparent lengthening. In later stages the hip is flexed, adducted and internally rotated, with apparent shortening.

Option by option

  • A. Apparent shortening of the limb

    Apparent shortening goes with the adduction deformity of the later stage.

  • B. True shortening of 3 cm

    True shortening needs destruction of the joint or physis.

  • C. No change in apparent length

    A change in apparent length occurs because of the pelvic tilt.

  • D. Apparent lengthening of the limb (correct)

    Correct. Abduction tilts the pelvis and creates apparent lengthening.

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 D, Apparent lengthening of the limb. In the early stage of tuberculous synovitis the hip is held flexed, abducted and externally rotated.

Why is "Apparent shortening of the limb" not the answer?

Apparent shortening goes with the adduction deformity of the later stage.

Why is "True shortening of 3 cm" not the answer?

True shortening needs destruction of the joint or physis.

Why is "No change in apparent length" not the answer?

A change in apparent length occurs because of the pelvic tilt.

What concept does this question test?

It tests Bone infection: early tuberculosis of the hip posture in Orthopaedics. Abduction tilts the pelvis down on that side, so the limb looks longer than the other, giving apparent lengthening. In later stages the hip is flexed, adducted and internally rotated, with apparent shortening.

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 infection: early tuberculosis of the hip posture?

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.