INI-CET 2022 — Orthopaedics

Q: The most common pattern of involvement in Pott's spine is

Paradiscal. ***Paradiscal*** - In **Pott's spine (tuberculous spondylitis)**, the infection typically starts in the anterior inferior aspect of the vertebral body and spreads to the adjacent disc space, making the **paradiscal** area the most common site of involvement. - This pattern is due to the rich **paradiscal vascular supply**, which facilitates the hematogenous spread of *Mycobacterium tuberculosis* to these regions. *Central* - **Central involvement** refers to the lesion being primarily located within the center of the vertebral body, which is less common in Pott's spine as the bacteria typically target the highly vascularized anterior and inferior margins. - While central lesions can occur, they are not the predominant pattern seen in initial stages of tuberculous spondylitis. *Posterior* - **Posterior involvement** usually refers to involvement of the posterior vertebral elements such as the neural arch, laminae, or spinous processes. - This type of involvement is **rare** in Pott's spine and is generally seen in very advanced or disseminated disease. *Anterior* - While the infection often begins in the anterior part of the vertebral body, the term **anterior** alone is less specific than "paradiscal" and doesn't fully capture the predominant involvement of the adjacent disc space. - The disease's characteristic spread across the disc space to an adjacent vertebra is a key feature of the paradiscal pattern, leading to **kyphosis** and vertebral collapse. [Practice more Orthopaedics PYQs on OnCourse]

Q: Combination of appearance in CTEV

Equinus, inversion, forefoot adduction, cavus. ***Equinus, inversion, forefoot adduction, cavus*** - The classic presentation of **clubfoot** (CTEV) involves a characteristic combination of deformities: **equinus** (fixed plantarflexion of the ankle), **inversion** (tilting of the heel inward), **forefoot adduction** (inward turning of the front of the foot), and **cavus** (an abnormally high arch). - These four components are essential for the diagnosis and classification of CTEV. *Equinus, eversion, forefoot adduction, cavus* - This option incorrectly lists **eversion** instead of inversion. Eversion involves the outward tilting of the heel and is not a feature of CTEV. - While equinus, forefoot adduction, and cavus are typical, the presence of eversion rules out classic CTEV. *Equinus, inversion, forefoot adduction, planus* - This option incorrectly lists **planus** (pes planus or flatfoot) instead of cavus. Cavus (high arch) is a defining characteristic of CTEV, not a flatfoot. - While equinus, inversion, and forefoot adduction are correct, the presence of planus makes this option incorrect. *Equinus, eversion, forefoot abduction, cavus* - This option incorrectly lists both **eversion** and **forefoot abduction**. Eversion is the outward tilting of the heel, and forefoot abduction is the outward turning of the front of the foot. - Both eversion and forefoot abduction are opposite to the deformities seen in classical CTEV. [Practice more Orthopaedics PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

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The most common pattern of involvement in Pott's spine is

Combination of appearance in CTEV