Neuroimaging: cerebral fat embolism: 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 · Neuroimaging: cerebral fat embolism

Sample item

A young man develops confusion, petechiae and hypoxia two days after a femoral fracture. MRI shows numerous tiny diffusion-restricting foci scattered in the white matter and basal ganglia. What is the likely cause?

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

The answer and the reasoning

D. Cerebral fat embolism with a starfield pattern

Fat embolism after long bone fracture produces scattered punctate infarcts, giving a starfield pattern on diffusion-weighted images. It is accompanied by respiratory distress and petechiae. Diffuse axonal injury shows haemorrhagic foci on susceptibility imaging after head trauma.

Option by option

  • A. Hypertensive microbleeds

    Hypertensive microbleeds appear on susceptibility imaging, not as restricted diffusion foci.

  • B. Multiple sclerosis

    Multiple sclerosis has periventricular ovoid plaques.

  • C. Diffuse axonal injury

    Diffuse axonal injury follows head trauma and bleeds at the grey-white junction.

  • D. Cerebral fat embolism with a starfield pattern (correct)

    Correct. Starfield DWI foci after a long bone fracture indicate fat embolism.

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 D, Cerebral fat embolism with a starfield pattern. Fat embolism after long bone fracture produces scattered punctate infarcts, giving a starfield pattern on diffusion-weighted images.

Why is "Hypertensive microbleeds" not the answer?

Hypertensive microbleeds appear on susceptibility imaging, not as restricted diffusion foci.

Why is "Multiple sclerosis" not the answer?

Multiple sclerosis has periventricular ovoid plaques.

Why is "Diffuse axonal injury" not the answer?

Diffuse axonal injury follows head trauma and bleeds at the grey-white junction.

What concept does this question test?

It tests Neuroimaging: cerebral fat embolism in Radiology. It is accompanied by respiratory distress and petechiae. Diffuse axonal injury shows haemorrhagic foci on susceptibility imaging after head trauma.

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 Neuroimaging: cerebral fat embolism?

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.