Nuclear medicine: three-phase bone scan: 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 · Nuclear medicine: three-phase bone scan

Sample item

A diabetic patient with a foot ulcer has a three-phase bone scan. Which pattern favours osteomyelitis rather than cellulitis alone?

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

The answer and the reasoning

B. Focal increased uptake in the delayed phase, localised to bone

In cellulitis, uptake is increased in the flow and blood-pool phases but fades on delayed images. Osteomyelitis shows persistent focal uptake in bone on the delayed phase. In neuropathic feet with deformity, labelled leucocyte imaging may be needed to separate infection from Charcot change.

Option by option

  • A. No uptake in any phase

    Osteomyelitis would not produce a completely normal scan.

  • B. Focal increased uptake in the delayed phase, localised to bone (correct)

    Correct. Persistent focal bone uptake indicates osteomyelitis.

  • C. Diffuse symmetric uptake in the feet

    Symmetric uptake suggests a systemic or metabolic process.

  • D. Increased uptake in the blood-flow and blood-pool phases only, fading on delayed images

    Early phase uptake that fades points to soft tissue infection.

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 B, Focal increased uptake in the delayed phase, localised to bone. In cellulitis, uptake is increased in the flow and blood-pool phases but fades on delayed images.

Why is "No uptake in any phase" not the answer?

Osteomyelitis would not produce a completely normal scan.

Why is "Diffuse symmetric uptake in the feet" not the answer?

Symmetric uptake suggests a systemic or metabolic process.

Why is "Increased uptake in the blood-flow and blood-pool phases only, fading…" not the answer?

Early phase uptake that fades points to soft tissue infection.

What concept does this question test?

It tests Nuclear medicine: three-phase bone scan in Radiology. Osteomyelitis shows persistent focal uptake in bone on the delayed phase. In neuropathic feet with deformity, labelled leucocyte imaging may be needed to separate infection from Charcot change.

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 Nuclear medicine: three-phase bone scan?

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.