Metabolic bone disease: first sign of rickets healing: 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 · Metabolic bone disease: first sign of rickets healing

Sample item

A child with active rickets starts treatment with vitamin D and calcium. Which is the earliest radiographic sign of healing?

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

The answer and the reasoning

B. A dense line of provisional calcification at the metaphysis

Within 2 to 4 weeks of treatment a thin, dense line of provisional calcification appears at the metaphyseal edge of the growth plate. The physeal width and cupping normalise over the following months, and deformities may take longer or need correction.

Option by option

  • A. Increase in the thickness of the cortex of the shaft

    Cortical thickening is slow and not an early marker.

  • B. A dense line of provisional calcification at the metaphysis (correct)

    Correct. A dense line of provisional calcification is the first sign that mineralisation has resumed.

  • C. Narrowing of the growth plate to normal width

    Growth plate narrowing follows the initial calcification line.

  • D. Disappearance of the genu varum deformity

    Deformity correction is a late and variable change.

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 B, A dense line of provisional calcification at the metaphysis. Within 2 to 4 weeks of treatment a thin, dense line of provisional calcification appears at the metaphyseal edge of the growth plate.

Why is "Increase in the thickness of the cortex of the shaft" not the answer?

Cortical thickening is slow and not an early marker.

Why is "Narrowing of the growth plate to normal width" not the answer?

Growth plate narrowing follows the initial calcification line.

Why is "Disappearance of the genu varum deformity" not the answer?

Deformity correction is a late and variable change.

What concept does this question test?

It tests Metabolic bone disease: first sign of rickets healing in Orthopaedics. The physeal width and cupping normalise over the following months, and deformities may take longer or need correction.

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 Metabolic bone disease: first sign of rickets healing?

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.