Inflammatory, degenerative and infective conditions of the hip

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QUESTION 1 OF 5

A 40-year-old man has been referred to the orthopaedic clinic with a 6-week history of (right) hip pain. The pain was unrelated to trauma and was a severe, deep aching groin pain worse at night. The patient has a limp with pain on weight bearing and a positive Trendelenburg sign. Radiographs of his hips are normal an MRI scan of his pelvis is shown (Figure 1).

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Figure 1.T2 weighted sagittal  MRI images pelvis 
The most likely diagnosis is

QUESTION ID: 1246

1. Bone marrow oedema syndrome
2. Infection (septic arthritis)
3. Osteochondromatosis
4. Osteonecrosis
5. Reflex sympathetic dystrophy
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QUESTION 2 OF 5

36.Osteonecrosis of the femoral head can result in subchondral collapse.
What is the pathophysiological cause of the loss of trabecular structural integrity?

QUESTION ID: 3232

1. Decreased blood flow.
2. Fat cell hypertrophy.
3. Osteocyte necrosis.
4. Reactive hyperaemia.
5. Resorption of bone.
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QUESTION 3 OF 5

37.When investigating the causative organism in an infected THA which would be your preferred method ?

QUESTION ID: 3233

1. Intra-operative frozen section
2. Intra-operative Gram stain
3. Percutaneous aspiration and culture
4. Polymerase chain reaction
5. Tissue culture of intra-operative biopsies
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QUESTION 4 OF 5

38. Which of the following pairings of causative factor and pathophysiological mechanism for femoral head osteonecrosis is incorrect?

QUESTION ID: 3234

1. Corticosteroids – fat cell hypertrophy.
2. Gaucher’s disease – intravascular coagulation.
3. Protein S deficiency – intravascular occlusion.
4. Sickle cell disease – intravascular coagulation.
5. Subcapital femur fracture – mechanical vascular interruption.
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QUESTION 5 OF 5

39.Which of the following mechanism occurs in the reparative stage of osteonecrosis?

QUESTION ID: 3235

1. Creeping substitution.
2. Enchondral ossification.
3. Intramembranous ossification.
4. Primary bone healing.
5. Secondary bone healing.
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