The Singh index on plain X-ray is used to assess osteoporosis. Which grade indicates threshold (borderline osteoporosis) where Ward's triangle trabecular group has disappeared but principal tensile and compressive groups are intact?

• A Singh Grade 6 (normal)
• B Singh Grade 3
• C Singh Grade 1 (severe)
• D Singh Grade 4 (borderline) ✓

Explanation

Singh Index grades femoral neck osteoporosis (Grades 1–6) based on trabecular groups visible on AP hip X-ray: Grade 6 — all 5 groups visible (normal); Grade 5 — secondary compressive group reduced; Grade 4 — secondary tensile group absent, Ward's triangle prominent (borderline); Grade 3 — secondary tensile group absent AND principal tensile group discontinuous; Grade 2 — only principal compressive group visible; Grade 1 — even principal compressive group reduced (severe). Grade ≤3 indicates established osteoporosis requiring treatment. Singh Grade 4 is the threshold/borderline value.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.