Musculoskeletal imaging: Hawkins sign: 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 · Musculoskeletal imaging: Hawkins sign

Sample item

Six weeks after fixation of a displaced talar neck fracture, an ankle mortise radiograph shows a thin subchondral lucent band in the talar dome. What does this finding indicate?

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

The answer and the reasoning

B. Preserved blood supply to the talar body

The Hawkins sign is subchondral lucency caused by disuse osteopenia of living bone and indicates the talar body has a viable blood supply. Its absence at six to eight weeks raises concern for avascular necrosis.

Option by option

  • A. Established avascular necrosis with collapse

    Established avascular necrosis shows a dense, sclerotic talar dome without the lucent band, later with collapse.

  • B. Preserved blood supply to the talar body (correct)

    Correct. Subchondral lucency from resorption in living bone shows the talar body is vascularised, making avascular necrosis unlikely.

  • C. Postoperative infection of the talus

    Infection produces lucency with periosteal reaction and soft-tissue changes, not a thin symmetrical subchondral band.

  • D. Nonunion of the talar neck

    Nonunion appears as a persistent fracture gap at the neck, not as subchondral lucency in the dome.

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 Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Preserved blood supply to the talar body. The Hawkins sign is subchondral lucency caused by disuse osteopenia of living bone and indicates the talar body has a viable blood supply.

Why is "Established avascular necrosis with collapse" not the answer?

Established avascular necrosis shows a dense, sclerotic talar dome without the lucent band, later with collapse.

Why is "Postoperative infection of the talus" not the answer?

Infection produces lucency with periosteal reaction and soft-tissue changes, not a thin symmetrical subchondral band.

Why is "Nonunion of the talar neck" not the answer?

Nonunion appears as a persistent fracture gap at the neck, not as subchondral lucency in the dome.

What concept does this question test?

It tests Musculoskeletal imaging: Hawkins sign in Radiology. Its absence at six to eight weeks raises concern for avascular necrosis.

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 Musculoskeletal imaging: Hawkins sign?

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.