NEET-PG 2020 - Orthopaedics PYQs Practice Questions

Q: What is the angle shown in the image known as?

Cobb angle. ***Correct Option: Cobb angle*** - The image displays a method for measuring the angle of a spinal curvature, which is known as the **Cobb angle** - This measurement is routinely used to assess the severity of **scoliosis** by drawing lines parallel to the vertebral endplates at the extreme ends of the curve and then determining the angle between these lines - The Cobb angle is the **gold standard** for quantifying scoliosis and monitoring curve progression *Incorrect Option: Bohler angle* - The **Bohler angle** is a measurement used in the assessment of **calcaneal fractures** - It is formed by two lines drawn on a lateral foot X-ray and is not relevant to spinal deformities *Incorrect Option: Ferguson angle* - The **Ferguson angle**, also known as the lumbosacral angle, measures the angle of the sacral base relative to the horizontal - It describes the degree of **lordosis** and is not used to quantify scoliosis as depicted in the image *Incorrect Option: Baumann angle* - The **Baumann angle** is an important measurement used in pediatric orthopedics to assess the alignment of the **distal humerus** after a supracondylar fracture - It is irrelevant to spinal imaging and curvature assessment [Practice more Orthopaedics PYQs on OnCourse]

Q: What is the most likely diagnosis based on the provided image?

Popeye's sign. ***Popeye's sign*** - The image shows a prominent bulge in the distal upper arm, which is characteristic of the **Popeye's sign**. - This sign indicates a **rupture of the long head of the biceps brachii tendon**, where the muscle belly retracts distally creating a visible lump. *Griesinger sign* - The **Griesinger sign** refers to edema and tenderness over the postero-inferior aspect of the mastoid process. - This sign is associated with **septic thrombosis of the mastoid emissary vein** or superior sagittal sinus thrombosis. *Rising sun sign* - The **rising sun sign** is a neuroimaging finding, referring to the upward displacement of the third ventricle and elevation of the cerebral hemispheres. - It is typically seen in cases of **hydrocephalus** or large suprasellar masses displacing brain structures. *Winner sign* - The **Winner sign** is a radiological finding seen in developmental dysplasia of the hip (DDH), specifically referring to a line drawn from the lateral corner of the acetabulum to the femoral shaft. - It assesses the **coverage of the femoral head** by the acetabulum, and its absence or abnormal position indicates DDH. [Practice more Orthopaedics PYQs on OnCourse]

Q: A 4-year-old child while playing suddenly had his elbow pulled by his servant maid's hand and is now continuously crying, not allowing anyone to touch his elbow. He is keeping his elbow extended. What is the most likely diagnosis?

Pulled elbow. ***Pulled elbow*** - This classic presentation involves a sudden pull on the extended arm, causing the **annular ligament** to slip over the **radial head**, characteristic of a pulled elbow (Nursemaid's elbow). - The child holds the arm in a pronated-extended position, refusing to use it due to pain, and cries when the elbow is touched, which aligns with the clinical picture. *Radial head fracture* - While a fracture can occur with trauma, a history of a distinct pulling mechanism and the absence of swelling or deformity make a **pulled elbow** more likely. - A radial head fracture would typically present with more localized pain and potentially **crepitus** or obvious swelling upon examination. *Supracondylar fracture* - This fracture usually results from a fall onto an outstretched hand, a different mechanism than described. - A supracondylar fracture would typically involve significant swelling, **ecchymosis**, and potential neurovascular compromise, which are not mentioned here. *Elbow dislocation* - Elbow dislocations usually result from high-energy trauma and present with obvious deformity and severe pain. - The history of a "pull" and the child holding the arm in an **extended, pronated position** are more consistent with a pulled elbow than a full dislocation. [Practice more Orthopaedics PYQs on OnCourse]

Q: A radiograph is obtained from a child with scoliosis. What is the name of the angle used to measure spinal curvature?

Cobb's Angle. **Cobb's Angle** - **Cobb's angle** is the primary method for measuring the severity of **scoliosis** on radiographs. - It is measured by drawing lines parallel to the superior endplate of the most tilted superior vertebra and the inferior endplate of the most tilted inferior vertebra of the curve; the angle between these two lines (or their perpendiculars) is the Cobb angle. *Bohler's Angle* - **Bohler's angle** is used in the assessment of **calcaneus fractures** and is measured on a lateral foot radiograph. - A decrease in this angle is indicative of a calcaneal fracture. *Ferguson's Angle* - **Ferguson's angle**, also known as the lumbosacral angle, measures the inclination of the sacrum relative to the horizontal in the standing position. - It is primarily used in the assessment of **spondylolisthesis** and other lumbosacral conditions. *Pauwels' Angle* - **Pauwels' angle** is used to classify **femoral neck fractures** based on the angle of the fracture line relative to the horizontal. - It helps determine the severity and stability of femoral neck fractures, guiding treatment decisions. [Practice more Orthopaedics PYQs on OnCourse]

Q: A 65-year-old female attended the Orthopaedics OPD with a chief complaint of chronic backache. The radiograph of the lumbar spine is obtained. What could be the most probable diagnosis?

Osteoporosis. ***Osteoporosis*** - Chronic backache in a 65-year-old female is a classic presentation of **osteoporosis**, often due to vertebral compression fractures. - Radiographs would show **decreased bone density**, possibly wedging or collapse of vertebral bodies. *Renal Osteodystrophy* - This condition is associated with **chronic kidney disease**, which is not mentioned in the patient's history. - Radiographic features typically include **subperiosteal bone resorption** (especially in phalanges), osteosclerosis ("rugger-jersey spine"), and bone cysts. *Paget's Disease* - Paget's disease is characterized by localized areas of **increased bone turnover**, resulting in disorganized and enlarged bone. - Radiographs would show characteristic features like **bone enlargement**, cortical thickening, and a "cotton wool" appearance, which is not suggested by general backache. *Rheumatoid Arthritis* - Rheumatoid arthritis primarily affects **synovial joints** and typically presents with symmetrical polyarthritis, morning stiffness, and swelling in peripheral joints, not isolated chronic backache. - While it can affect the cervical spine, it rarely presents as isolated chronic low back pain in this age group and has specific radiographic changes like **joint erosions** and narrowing not indicative of osteoporosis. [Practice more Orthopaedics PYQs on OnCourse]

Question 1

What is the angle shown in the image known as?

Accepted Answer

Cobb angle

Answer

Bohler angle

Answer

Ferguson angle

Answer

Baumann angle

Question 2

What is the most likely diagnosis based on the provided image?

Accepted Answer

Popeye's sign

Answer

Griesinger sign

Answer

Rising sun sign

Answer

Winner sign

Question 3

A 4-year-old child while playing suddenly had his elbow pulled by his servant maid's hand and is now continuously crying, not allowing anyone to touch his elbow. He is keeping his elbow extended. What is the most likely diagnosis?

Accepted Answer

Pulled elbow

Answer

Radial head fracture

Answer

Elbow dislocation

Answer

Supracondylar fracture

Question 4

A radiograph is obtained from a child with scoliosis. What is the name of the angle used to measure spinal curvature?

Accepted Answer

Cobb's Angle

Answer

Bohler's Angle

Answer

Ferguson's Angle

Answer

Pauwels' Angle

Question 5

A 65-year-old female attended the Orthopaedics OPD with a chief complaint of chronic backache. The radiograph of the lumbar spine is obtained. What could be the most probable diagnosis?

Accepted Answer

Osteoporosis

Answer

Renal Osteodystrophy

Answer

Paget's Disease

Answer

Rheumatoid Arthritis

NEET-PG 2020 — Orthopaedics