Orthopaedics: septic arthritis: practice question

A Pediatrics 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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Pediatrics · Orthopaedics: septic arthritis

Sample item

A 3-year-old with fever refuses to bear weight and holds the hip flexed, abducted and externally rotated. Pain is severe with passive movement and ESR is raised. What is the most important step?

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

The answer and the reasoning

C. Urgent aspiration or arthrotomy with antibiotics

Septic arthritis is an orthopaedic emergency because cartilage destruction and avascular necrosis of the femoral head occur rapidly. Joint aspiration and drainage along with intravenous antibiotics covering Staphylococcus aureus are required. Kocher criteria help differentiate it from transient synovitis.

Option by option

  • A. Plaster immobilisation alone

    Immobilisation alone does not treat infection.

  • B. MRI after 2 weeks

    Waiting 2 weeks is dangerous.

  • C. Urgent aspiration or arthrotomy with antibiotics (correct)

    Correct. Drainage and antibiotics are urgent.

  • D. Oral analgesics and review in a week

    Delay risks joint destruction.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Urgent aspiration or arthrotomy with antibiotics. Septic arthritis is an orthopaedic emergency because cartilage destruction and avascular necrosis of the femoral head occur rapidly.

Why is "Plaster immobilisation alone" not the answer?

Immobilisation alone does not treat infection.

Why is "MRI after 2 weeks" not the answer?

Waiting 2 weeks is dangerous.

Why is "Oral analgesics and review in a week" not the answer?

Delay risks joint destruction.

What concept does this question test?

It tests Orthopaedics: septic arthritis in Pediatrics. Joint aspiration and drainage along with intravenous antibiotics covering Staphylococcus aureus are required. Kocher criteria help differentiate it from transient synovitis.

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 Orthopaedics: septic arthritis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.