Bone and joint infections: posture in tuberculosis of the hip: 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 infections: posture in tuberculosis of the hip

Sample item

In tuberculosis of the hip, the early stage of synovitis places the limb in flexion, abduction and external rotation with apparent lengthening. Which posture characterises the later stage of arthritis?

AFlexion, abduction and internal rotation, with true shorteningBFlexion, abduction and external rotation, with apparent lengtheningCExtension, abduction and internal rotation, with true lengtheningDFlexion, adduction and internal rotation, with apparent shortening

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

The answer and the reasoning

D. Flexion, adduction and internal rotation, with apparent shortening

In the stage of synovitis the capsule is distended and the hip rests in flexion, abduction and external rotation. As arthritis develops, spasm and contracture pull the limb into flexion, adduction and internal rotation, which tilts the pelvis and produces apparent shortening. Later destruction can add true shortening.

Option by option

A. Flexion, abduction and internal rotation, with true shortening
Abduction with internal rotation does not describe either stage.
B. Flexion, abduction and external rotation, with apparent lengthening
This is the posture of the earlier synovitis stage, with apparent lengthening.
C. Extension, abduction and internal rotation, with true lengthening
Extension with abduction and true lengthening is not a recognised posture of this disease.
D. Flexion, adduction and internal rotation, with apparent shortening (correct)
Correct. Adduction and internal rotation with pelvic tilt produce apparent shortening in the stage of arthritis.

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, Flexion, adduction and internal rotation, with apparent shortening. In the stage of synovitis the capsule is distended and the hip rests in flexion, abduction and external rotation.

Why is "Flexion, abduction and internal rotation, with true shortening" not the answer?

Abduction with internal rotation does not describe either stage.

Why is "Flexion, abduction and external rotation, with apparent lengthening" not the answer?

This is the posture of the earlier synovitis stage, with apparent lengthening.

Why is "Extension, abduction and internal rotation, with true lengthening" not the answer?

Extension with abduction and true lengthening is not a recognised posture of this disease.

What concept does this question test?

It tests Bone and joint infections: posture in tuberculosis of the hip in Orthopaedics. As arthritis develops, spasm and contracture pull the limb into flexion, adduction and internal rotation, which tilts the pelvis and produces apparent shortening. Later destruction can add true 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 and joint infections: posture in tuberculosis of the hip?

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.