Bone infection: chronic recurrent multifocal 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.

Try it

Orthopaedics · Bone infection: chronic recurrent multifocal osteomyelitis

Sample item

A 10-year-old girl has recurrent bone pain at several metaphyseal sites, including the clavicle, with raised ESR. Repeated biopsies and cultures show chronic inflammation but no organism. Which diagnosis is likely?

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

The answer and the reasoning

C. Chronic recurrent multifocal osteomyelitis

Chronic recurrent multifocal osteomyelitis is a sterile autoinflammatory bone condition of children, with painful metaphyseal lesions in several bones, often the clavicle. Cultures are negative, and it is part of the SAPHO spectrum. NSAIDs are first-line, with bisphosphonates for refractory cases.

Option by option

  • A. Ewing sarcoma

    Ewing sarcoma is typically solitary and shows a malignant small round cell tumour on biopsy.

  • B. Brodie abscess

    Brodie abscess is a solitary subacute abscess in a metaphysis.

  • C. Chronic recurrent multifocal osteomyelitis (correct)

    Correct. Sterile multifocal metaphyseal lesions in a child suggest CRMO.

  • D. Acute haematogenous osteomyelitis

    Acute haematogenous osteomyelitis is a bacterial infection with positive cultures and fever.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Chronic recurrent multifocal osteomyelitis. Chronic recurrent multifocal osteomyelitis is a sterile autoinflammatory bone condition of children, with painful metaphyseal lesions in several bones, often the clavicle.

Why is "Ewing sarcoma" not the answer?

Ewing sarcoma is typically solitary and shows a malignant small round cell tumour on biopsy.

Why is "Brodie abscess" not the answer?

Brodie abscess is a solitary subacute abscess in a metaphysis.

Why is "Acute haematogenous osteomyelitis" not the answer?

Acute haematogenous osteomyelitis is a bacterial infection with positive cultures and fever.

What concept does this question test?

It tests Bone infection: chronic recurrent multifocal osteomyelitis in Orthopaedics. Cultures are negative, and it is part of the SAPHO spectrum. NSAIDs are first-line, with bisphosphonates for refractory cases.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: chronic recurrent multifocal 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.