Musculoskeletal imaging: Brodie abscess: practice question

A Radiology 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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Radiology · Musculoskeletal imaging: Brodie abscess

Sample item

A 14-year-old has months of dull, night-worse pain in the tibia with no fever. Radiograph shows a metaphyseal lucent cavity with a sclerotic rim and a small channel toward the physis. What is the diagnosis?

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

The answer and the reasoning

A. Brodie abscess (subacute osteomyelitis)

A Brodie abscess is a localised subacute infection with a lucent cavity and surrounding sclerosis, typically in the metaphysis of a child. Osteoid osteoma has a small nidus smaller than 1.5 cm in thick sclerosis. Ewing sarcoma shows permeative destruction and a soft tissue mass.

Option by option

  • A. Brodie abscess (subacute osteomyelitis) (correct)

    Correct. A lucent cavity with a sclerotic rim is a Brodie abscess.

  • B. Osteoid osteoma

    Osteoid osteoma has a tiny nidus without a channel to the physis.

  • C. Eosinophilic granuloma

    Eosinophilic granuloma is a punched-out lytic lesion without a thick sclerotic rim.

  • D. Ewing sarcoma

    Ewing sarcoma is permeative with an onion skin reaction and a mass.

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 Radiology question

What is the answer to this Radiology question?

The best answer is A, Brodie abscess (subacute osteomyelitis). A Brodie abscess is a localised subacute infection with a lucent cavity and surrounding sclerosis, typically in the metaphysis of a child.

Why is "Osteoid osteoma" not the answer?

Osteoid osteoma has a tiny nidus without a channel to the physis.

Why is "Eosinophilic granuloma" not the answer?

Eosinophilic granuloma is a punched-out lytic lesion without a thick sclerotic rim.

Why is "Ewing sarcoma" not the answer?

Ewing sarcoma is permeative with an onion skin reaction and a mass.

What concept does this question test?

It tests Musculoskeletal imaging: Brodie abscess in Radiology. Osteoid osteoma has a small nidus smaller than 1.5 cm in thick sclerosis. Ewing sarcoma shows permeative destruction and a soft tissue mass.

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 Musculoskeletal imaging: Brodie abscess?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.