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Review Question - QID 6196

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QID 6196 (Type "6196" in App Search)
A 48-year-old woman reports bilateral thigh pain that is limiting her function as a librarian. A radiograph and a bone scan are shown in Figures 23a and 23b. What is the most likely diagnosis?
  • A
  • B

Ankylosing spondylitis

5%

25/464

Arthrokatadysis

12%

58/464

Osteomalacia

5%

21/464

Rheumatoid arthritis

75%

348/464

Developmental dysplasia

2%

9/464

  • A
  • B

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The radiograph reveals bilateral severe acetabular protrusio. The bone scan and history confirm involvement of multiple joints, including the knees and the hindfoot. Although the first four choices can all cause the acetabular protrusio, the associated multiple joint involvement suggests the diagnosis of rheumatoid arthritis. Arthrokatadysis, or primary protrusio acetabuli, is often associated with osteomalacia but not other joint disease. Developmental dysplasia is a common cause of bilateral hip pathology but does not have acetabular protrusio.

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