Bone tumours: benign: 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.

Try it

Orthopaedics · Bone tumours: benign

Sample item

A 15-year-old boy has a hard, painless bony swelling near the knee that grows with him. X-ray shows a pedunculated bony outgrowth from the metaphysis directed away from the joint, continuous with the marrow cavity. What is the diagnosis, and which feature in adulthood suggests malignant change?

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

The answer and the reasoning

C. Osteochondroma; growth after skeletal maturity or a thick cartilage cap suggests chondrosarcoma

Osteochondroma is the commonest benign bone tumour, a cartilage-capped outgrowth that points away from the physis and is continuous with the medullary cavity. It stops growing at skeletal maturity. New growth in adulthood, pain, or a cartilage cap thicker than about 2 cm should raise suspicion of secondary chondrosarcoma, which is more likely in multiple hereditary exostoses.

Option by option

  • A. Ewing sarcoma; onion-skin periosteal reaction

    Ewing sarcoma is a destructive lesion with an onion-skin reaction.

  • B. Giant cell tumour; pain on weight bearing

    Giant cell tumour is epiphyseal in adults after growth plate closure.

  • C. Osteochondroma; growth after skeletal maturity or a thick cartilage cap suggests chondrosarcoma (correct)

    Correct. The imaging features are typical, and renewed growth in an adult suggests malignant change.

  • D. Osteoid osteoma; relief with aspirin

    Osteoid osteoma is a small nidus with night pain relieved by NSAIDs, not a pedunculated outgrowth.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Osteochondroma; growth after skeletal maturity or a thick cartilage cap suggests chondrosarcoma. Osteochondroma is the commonest benign bone tumour, a cartilage-capped outgrowth that points away from the physis and is continuous with the medullary cavity.

Why is "Ewing sarcoma; onion-skin periosteal reaction" not the answer?

Ewing sarcoma is a destructive lesion with an onion-skin reaction.

Why is "Giant cell tumour; pain on weight bearing" not the answer?

Giant cell tumour is epiphyseal in adults after growth plate closure.

Why is "Osteoid osteoma; relief with aspirin" not the answer?

Osteoid osteoma is a small nidus with night pain relieved by NSAIDs, not a pedunculated outgrowth.

What concept does this question test?

It tests Bone tumours: benign in Orthopaedics. It stops growing at skeletal maturity. New growth in adulthood, pain, or a cartilage cap thicker than about 2 cm should raise suspicion of secondary chondrosarcoma, which is more likely in multiple hereditary exostoses.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: benign?

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.