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Radiology · Musculoskeletal imaging: infantile cortical hyperostosis
Sample itemA 3-month-old irritable infant has fever and firm swelling of the jaw. Radiographs show thick layers of periosteal new bone along the mandible, clavicle and ulna. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Infantile cortical hyperostosis (Caffey disease)
Caffey disease presents before 5 months of age with irritability, fever and soft-tissue swelling, with exuberant periosteal new bone most often in the mandible, clavicle and ulna. It is self-limiting.
Option by option
A. Infantile cortical hyperostosis (Caffey disease) (correct)
Correct. Early infantile fever with mandibular swelling and diffuse cortical thickening is Caffey disease.
B. Scurvy
Scurvy occurs after about 6 months, with metaphyseal changes and subperiosteal haemorrhage.
C. Acute osteomyelitis
Acute osteomyelitis is usually solitary, with a destructive metaphyseal focus, not symmetrical multifocal hyperostosis.
D. Non-accidental injury
Non-accidental injury produces fractures at different stages of healing, such as metaphyseal corner fractures and rib fractures.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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