National Physical Therapy Examination (NPTE) Practice Exam

What is the most likely condition associated with a patient exhibiting insidious onset of pain inferior to the glenohumeral joint combined with elevated alkaline phosphatase levels?

1. Actinomycosis and osteomalacia

2. Pyogenic infection and cellulitis

3. Septic arthritis and ectopic bone formation

4. Granulomatous infection and thrombophlebitis

The correct answer is: Septic arthritis and ectopic bone formation

The condition characterized by insidious onset of pain inferior to the glenohumeral joint, combined with elevated alkaline phosphatase levels, is most closely aligned with septic arthritis and ectopic bone formation. Septic arthritis typically presents with joint pain and inflammation, and although it is often acute, it can occasionally have an insidious onset, especially in cases where there is an underlying chronic infection or advanced disease processes. The combination of joint pain and elevated alkaline phosphatase levels suggests a disruption in bone metabolism, which can occur with ectopic bone formation. Ectopic bone formation can be seen in various conditions, including infections where the inflammatory response triggers abnormal bone growth. While other conditions mentioned might involve pain or inflammation, they do not directly correlate with the specific combination of insidious pain and elevated alkaline phosphatase seen here. Conditions like actinomycosis and osteomalacia primarily involve different symptoms or lab findings, whereas pyogenic infections, though acute and painful, typically do not present with the specific chronic pain pattern or alkaline phosphatase levels associated with ectopic bone growth. Granulomatous infections and thrombophlebitis also do not fit the clinical picture as neatly in terms of both pain location and specific lab findings.