Metabolic bone disease: aluminium bone disease: 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 · Metabolic bone disease: aluminium bone disease

Sample item

A dialysis patient taking aluminium hydroxide as a phosphate binder for many years has bone pain and fractures. PTH is low and a bone biopsy shows osteomalacia with aluminium at the mineralisation front. What is the diagnosis?

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

The answer and the reasoning

D. Aluminium-related low-turnover bone disease

Aluminium deposited at the mineralisation front blocks mineralisation and suppresses PTH, causing low-turnover osteomalacia and adynamic bone. Avoidance of aluminium-based binders and chelation prevent and treat it.

Option by option

  • A. Brown tumour of hyperparathyroidism

    A brown tumour arises from severe hyperparathyroidism with raised PTH.

  • B. Osteitis fibrosa cystica

    Osteitis fibrosa cystica comes from high PTH with a high-turnover pattern.

  • C. Dialysis-related amyloid arthropathy

    Amyloid arthropathy results from beta-2 microglobulin deposition, not from aluminium.

  • D. Aluminium-related low-turnover bone disease (correct)

    Correct. Aluminium at the mineralisation front with low PTH identifies aluminium bone disease.

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 D, Aluminium-related low-turnover bone disease. Aluminium deposited at the mineralisation front blocks mineralisation and suppresses PTH, causing low-turnover osteomalacia and adynamic bone.

Why is "Brown tumour of hyperparathyroidism" not the answer?

A brown tumour arises from severe hyperparathyroidism with raised PTH.

Why is "Osteitis fibrosa cystica" not the answer?

Osteitis fibrosa cystica comes from high PTH with a high-turnover pattern.

Why is "Dialysis-related amyloid arthropathy" not the answer?

Amyloid arthropathy results from beta-2 microglobulin deposition, not from aluminium.

What concept does this question test?

It tests Metabolic bone disease: aluminium bone disease in Orthopaedics. Avoidance of aluminium-based binders and chelation prevent and treat it.

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 Metabolic bone disease: aluminium bone disease?

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.