Fracture complications: bone scan in CRPS: 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 · Fracture complications: bone scan in CRPS

Sample item

A man has persistent pain, allodynia and skin colour change in the foot three months after an ankle fracture. Plain films are equivocal and a three-phase bone scan is requested. Which pattern supports complex regional pain syndrome?

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

The answer and the reasoning

A. Diffusely increased periarticular uptake in the delayed phase

In complex regional pain syndrome the delayed images of a three-phase bone scan typically show diffuse increased periarticular uptake in the affected limb, reflecting regional hyperaemia and increased bone turnover. It supports a clinical diagnosis but is not mandatory. Absent uptake would suggest infarction rather than this syndrome.

Option by option

  • A. Diffusely increased periarticular uptake in the delayed phase (correct)

    Correct. Increased periarticular delayed uptake is the typical scan pattern.

  • B. A single focal hot spot at the fracture site only

    A focal fracture-site hot spot is normal healing and is not specific.

  • C. Absent uptake throughout the foot in all phases

    Absent uptake suggests avascularity and does not fit this picture.

  • D. Uniformly reduced uptake in all bones of the body

    Generalised low uptake does not describe this condition.

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 A, Diffusely increased periarticular uptake in the delayed phase. In complex regional pain syndrome the delayed images of a three-phase bone scan typically show diffuse increased periarticular uptake in the affected limb, reflecting regional hyperaemia and increased bone turnover.

Why is "A single focal hot spot at the fracture site only" not the answer?

A focal fracture-site hot spot is normal healing and is not specific.

Why is "Absent uptake throughout the foot in all phases" not the answer?

Absent uptake suggests avascularity and does not fit this picture.

Why is "Uniformly reduced uptake in all bones of the body" not the answer?

Generalised low uptake does not describe this condition.

What concept does this question test?

It tests Fracture complications: bone scan in CRPS in Orthopaedics. It supports a clinical diagnosis but is not mandatory. Absent uptake would suggest infarction rather than this syndrome.

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 Fracture complications: bone scan in CRPS?

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.