Paediatric orthopaedics: Perthes disease: 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 · Paediatric orthopaedics: Perthes disease

Sample item

A 6-year-old boy has a painless limp, and a radiograph shows a small, dense capital femoral epiphysis. What is the main principle of treatment?

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

The answer and the reasoning

B. Containment of the femoral head within the acetabulum

In Perthes disease, the necrotic head is soft and remodels, so treatment aims to keep it contained in the acetabulum with bracing or osteotomy. This gives a spherical head as it heals.

Option by option

  • A. Long-term hip spica for two years

    Prolonged spica casting gives stiffness and no benefit.

  • B. Containment of the femoral head within the acetabulum (correct)

    Correct. Containment protects the head while it remodels.

  • C. Intravenous antibiotics

    This is an avascular necrosis and not an infection.

  • D. Immediate total hip replacement

    Replacement is not performed in a child with this condition.

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 B, Containment of the femoral head within the acetabulum. In Perthes disease, the necrotic head is soft and remodels, so treatment aims to keep it contained in the acetabulum with bracing or osteotomy.

Why is "Long-term hip spica for two years" not the answer?

Prolonged spica casting gives stiffness and no benefit.

Why is "Intravenous antibiotics" not the answer?

This is an avascular necrosis and not an infection.

Why is "Immediate total hip replacement" not the answer?

Replacement is not performed in a child with this condition.

What concept does this question test?

It tests Paediatric orthopaedics: Perthes disease in Orthopaedics. This gives a spherical head as it heals.

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 Paediatric orthopaedics: Perthes disease?

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.