Bone tumours: osteoid osteoma of the spine: 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 tumours: osteoid osteoma of the spine

Sample item

A 14-year-old has a painful scoliosis with pain that is worse at night and relieved by ibuprofen. CT shows a small lucent nidus in the posterior elements at the concavity of the curve. What is the likely cause of the scoliosis?

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

The answer and the reasoning

A. Osteoid osteoma causing a painful scoliosis

A painful scoliosis in a child is atypical for idiopathic scoliosis and should prompt a search for a cause. Osteoid osteoma of the posterior elements causes muscle spasm that produces a curve, with the nidus typically on the concave side. Removal of the nidus often resolves the curve in early cases.

Option by option

  • A. Osteoid osteoma causing a painful scoliosis (correct)

    Correct. Night pain relieved by NSAIDs and a nidus indicate osteoid osteoma.

  • B. Adolescent idiopathic scoliosis

    Idiopathic scoliosis is classically painless.

  • C. Scheuermann disease

    Scheuermann disease is a sagittal deformity with wedged vertebrae.

  • D. Neuromuscular scoliosis

    Neuromuscular scoliosis accompanies a neurological disorder.

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, Osteoid osteoma causing a painful scoliosis. A painful scoliosis in a child is atypical for idiopathic scoliosis and should prompt a search for a cause.

Why is "Adolescent idiopathic scoliosis" not the answer?

Idiopathic scoliosis is classically painless.

Why is "Scheuermann disease" not the answer?

Scheuermann disease is a sagittal deformity with wedged vertebrae.

Why is "Neuromuscular scoliosis" not the answer?

Neuromuscular scoliosis accompanies a neurological disorder.

What concept does this question test?

It tests Bone tumours: osteoid osteoma of the spine in Orthopaedics. Osteoid osteoma of the posterior elements causes muscle spasm that produces a curve, with the nidus typically on the concave side. Removal of the nidus often resolves the curve in early 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 tumours: osteoid osteoma of the spine?

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.