Paediatric infections: osteomyelitis: practice question

A Pediatrics 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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Pediatrics · Paediatric infections: osteomyelitis

Sample item

A 7-year-old has fever and acute pain with refusal to bear weight on the right leg, localised tenderness over the distal femur and raised CRP. Which organism and imaging choice are best?

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

The answer and the reasoning

B. Staphylococcus aureus; MRI as the most sensitive early investigation

Staphylococcus aureus is the commonest cause of acute haematogenous osteomyelitis in children. Plain X-rays are normal in the first 10 days, so MRI is the most sensitive early test, and antibiotics are given for 3 to 6 weeks.

Option by option

  • A. Mycobacterium; ultrasound only

    Tuberculous osteomyelitis is subacute and ultrasound is insufficient.

  • B. Staphylococcus aureus; MRI as the most sensitive early investigation (correct)

    Correct. S aureus and MRI are best.

  • C. Salmonella; plain X-ray on day 1 as the best test

    Plain X-ray is normal early, and Salmonella is typical in sickle cell disease.

  • D. Pseudomonas; bone scan only

    Pseudomonas is associated with puncture wounds of the foot.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Staphylococcus aureus; MRI as the most sensitive early investigation. Staphylococcus aureus is the commonest cause of acute haematogenous osteomyelitis in children.

Why is "Mycobacterium; ultrasound only" not the answer?

Tuberculous osteomyelitis is subacute and ultrasound is insufficient.

Why is "Salmonella; plain X-ray on day 1 as the best test" not the answer?

Plain X-ray is normal early, and Salmonella is typical in sickle cell disease.

Why is "Pseudomonas; bone scan only" not the answer?

Pseudomonas is associated with puncture wounds of the foot.

What concept does this question test?

It tests Paediatric infections: osteomyelitis in Pediatrics. Plain X-rays are normal in the first 10 days, so MRI is the most sensitive early test, and antibiotics are given for 3 to 6 weeks.

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 Paediatric infections: osteomyelitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.