Bone infection: imaging in early osteomyelitis: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone infection: imaging in early osteomyelitis

Sample item

A child has fever and bone pain for 3 days. Plain radiographs show only soft tissue swelling. Which investigation best confirms early osteomyelitis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. MRI

Radiographic bone changes such as periosteal reaction and lucency take 10 to 14 days to appear. MRI shows marrow oedema and abscesses early, and a bone scan is also sensitive. Blood cultures and antibiotics should not be delayed.

Option by option

  • A. Repeat radiograph after 24 hours

    A repeat film after 24 hours will still be normal.

  • B. Ultrasound of the liver

    Liver ultrasound is irrelevant.

  • C. DEXA scan

    DEXA assesses bone density only.

  • D. MRI (correct)

    Correct. MRI detects marrow changes within days.

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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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, MRI. Radiographic bone changes such as periosteal reaction and lucency take 10 to 14 days to appear.

Why is "Repeat radiograph after 24 hours" not the answer?

A repeat film after 24 hours will still be normal.

Why is "Ultrasound of the liver" not the answer?

Liver ultrasound is irrelevant.

Why is "DEXA scan" not the answer?

DEXA assesses bone density only.

What concept does this question test?

It tests Bone infection: imaging in early osteomyelitis in Orthopaedics. MRI shows marrow oedema and abscesses early, and a bone scan is also sensitive. Blood cultures and antibiotics should not be delayed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone infection: imaging in early osteomyelitis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.